Issues for Surgery
For treatment of heart failure – risk of exacerbation of heart failure symptoms if omitted.
Potential for digoxin toxicity if continued.
Advice in the Perioperative period
Consider monitoring serum digoxin levels if toxicity suspected (see Interaction(s) with Common Anaesthetic Agents, Interaction(s) with other Common Medicines used in the Perioperative Period and Further Information).
Interaction(s) with Common Anaesthetic Agents
Cisatracurium can increase the risk of bradycardia1.
Interaction(s) with other Common Medicines used in the Perioperative Period
Whilst single perioperative doses should not pose a problem, continued post-operative treatment may require close monitoring. Consult current product literature.
Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
Digoxin levels should be monitored whenever an NSAID is initiated or discontinued2, 4.