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August 2024 Br J Cardiol 2024;31(suppl 3):S19–S23 doi:10.5837/bjc.2024.s10

Digoxin: monitoring, limitations of its use, and managing toxicity

Paul J Andrews, Harvey Thompson

Abstract

Laboratory testing of digoxin levels Laboratories in the National Health Service (NHS) acute trusts will have arrangements in place for routine therapeutic drug level monitoring of digoxin. Routine assays may not be available on a daily basis. However, local arrangements should exist to ensure the availability of urgent testing in cases of suspected digoxin toxicity 24 hours a day. One commonly used method is the electro-chemiluminescence immunoassay (Roche ECLIA®). This assay involves adding a combination of Ruthenium-labelled digoxin-specific monoclonal antibodies, a digoxin derivative labelled with biotin, and a fluorescent marker attache

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