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Digoxin: its role in contemporary medicine
  1. Marcelle A Stucky1,
  2. Zachary D Goldberger1,2
  1. 1Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2Division of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA
  1. Correspondence to Dr Zachary D Goldberger, Division of Cardiology, Harborview Medical Center, 325 9th Avenue, Box 359748, Seattle, WA 98104, USA; zgoldber{at}


Digoxin has been a key therapeutic for heart failure and atrial tachyarrhythmias for over 200 years following Withering's groundbreaking work depicting the therapeutic benefit of the common botanical foxglove in his 1785 monograph. The use of digoxin preceded any randomised evidence or even basic understanding of its mechanism of action. Over the past two decades, there has been mounting evidence further challenging the safety and efficacy of digoxin, while multiple other therapies for both heart failure and atrial tachyarrhythmias have proven to be more effective and safe. Altogether, digoxin still has an important role in contemporary pharmacotherapeutics, though its role remains controversial and should be reserved for selective patients and clinical situations, with careful attention to serum concentrations.


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