Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services now if someone taking digoxin has:
Collapsed, fainted, or cannot be awakened normally
A seizure
Severe trouble breathing
A very slow, very fast, or markedly irregular heartbeat with weakness or dizziness
Signs of shock, such as cold clammy skin and reduced responsiveness
Taken a large or unknown amount of digoxin
Swallowed digoxin intentionally
A suspected ingestion by a child also needs immediate poison-centre or emergency advice, even if the child appears well.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Do not wait for symptoms and do not induce vomiting.
Seek urgent same-day medical advice for new nausea, repeated vomiting, poor appetite, confusion, unusual weakness, colour-vision changes, or palpitations while taking digoxin.
Also seek prompt advice if you may have taken extra doses or have become dehydrated.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate when you feel well but need a planned medication review, kidney testing, or monitoring after a change in treatment.
Every sign above is quoted from the sofidex article on Digitalis toxicity. If you are not sure, err upward — it is always reasonable to be checked.