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Digoxin toxicity — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDigoxin toxicityGPhC CRA

An 82-year-old woman taking digoxin 125 micrograms daily reports nausea, blurred vision and unusual yellow-green visual disturbance. She was recently started on clarithromycin for a chest infection. Her pulse is 52 bpm. What is the most important interaction to flag?

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Correct answer: C — Clarithromycin may increase digoxin exposure and toxicity

Macrolides can increase digoxin exposure, partly through effects on gut flora and P-glycoprotein. The symptoms and bradycardia are concerning for digoxin toxicity. The pharmacist should advise urgent medical review rather than continuing both medicines without assessment.

Reference: BNF