What Is the Connection between Digoxin and Hypokalemia?

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  • Written By: T. Carrier
  • Edited By: John Allen
  • Last Modified Date: 09 February 2019
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Any prescription medication may have undesirable side effects, and for certain portions of a population these side effects are enhanced. The heart disease medication digoxin — also known as digitalis — is one such medicine. Evidence suggests a particularly negative association between digoxin and hypokalemia, which is a condition characterized by lower than normal amounts of potassium in the body. This consequence may result from the drug's impact on an important potassium-binding bodily area. Antibodies and potassium supplements are potential solutions to this quandary.

Uses of digoxin commonly relate to treating heart ailments. Is is particularly helpful in addressing issues with the heart's atrium. The drug changes sodium an calcium levels within and around heart cells. This action then slows the heart rate. Many physicians now consider this substance a last resort drug, however.

Hypokalemia refers to a lack of potassium in the body. This mineral conducts electricity in the body, and is thus highly important in heart function. It also helps body tissues — particularly smooth muscle — function at an adequate and efficient level. Individuals with imbalances in their sodium or magnesium blood levels are more susceptible to hypokalemia. Aches, irregular heartbeats, and generalized weakness are some of the chief indicators of hypokalemia, and if left untreated, the condition could prove life-threatening.


The primary connection between digoxin and hypokalemia is the potential for negative reactions in patients with hypokalemia who take digoxin. When it enters the body, digoxin binds to a place known as the sodium-potassium pump. Potassium also binds to this area, which creates a situation where one substance will not work properly in the body. Consequently, the digoxin may further deprive a body already depleted in potassium of this needed substance, or the potassium competition may cause digoxin to become toxic. In fact, potential complications of digoxin are much more prominent in patients with hypokalemia than in the general population.

A parasitic relationship between digoxin and hypokalemia may cause several adverse side effects. More common side effects of digoxin are related to the gastrointestinal tract and include loss of appetite, diarrhea, and nausea and vomiting. The lack of potassium can also impact cognition and emotions, leading to complications such as depression, irritability, and confusion or forgetfulness. Vision and sleeping ability may be hindered as well. In rarer cases, a patient may suffer mentally from bouts of delirium or psychosis.

Ironically, an overdose of digoxin can also facilitate abnormally high potassium levels. This opposite risk of digoxin and hypokalemia occurs when elevated amounts of the drug in effect paralyze the pump that binds both digoxin and potassium. Too much potassium or too little potassium can both pose risks to the body.

In general, the treatment for many digoxin and hypokalemia effects is providing the body with more potassium. Antibodies may also be used that remove digoxin. Such steps are typically only needed in the case of digoxin overdose.


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