Digoxin level
Drug LevelsNormal range
0.5–2.0 ng/mL (HF goal often 0.5–0.9)
SI: 0.6–2.6 nmol/L
Critical high: > 2.4 ng/mL
☎ When to call
Suspected toxicity (GI + visual + arrhythmia), level > 2, or bradycardia with the level pending — hold and call. DigiFab is the antidote for serious toxicity.
What you do
- Toxicity signs: nausea, anorexia, visual halos/yellow tint, new arrhythmia — ASK, don't wait for the level
- Check apical pulse a full minute before each dose; hold below ordered threshold (usually < 60)
- Check the K — low potassium makes normal-level dig toxic
- Draw levels ≥ 6h after the dose
Causes of HIGH digoxin level
Causes of LOW digoxin level
Source: Pagana, Mosby's Manual of Diagnostic and Laboratory Tests, 7th ed.; Lehne's PharmacologyReference only — verify against your facility's policy.
