Digoxin therapeutic level
The therapeutic digoxin level is 0.8 to 2 ng/mL. A level above 2 ng/mL is toxic. Just as important, a low potassium (under 3.5) can cause toxicity even when the digoxin level itself reads normal, so the potassium is checked alongside it.
What the digoxin level tells you, and why the NCLEX tests it
Digoxin has a narrow safety margin, so the exam constantly hands you a level and a potassium and asks whether it is safe to give the dose. Knowing the numbers and the potassium connection answers the question.
Key nursing considerations for the digoxin level
0.8 to 2 ng/mL.
Above 2 ng/mL is toxic.
Low potassium (under 3.5) worsens toxicity even at a normal level, and diuretics that lower potassium are often given with digoxin.
Anorexia, nausea, vomiting, yellow-green visual halos, confusion, and bradycardia.
Take an apical pulse for a full minute, hold for under 60 or signs of toxicity, notify, and anticipate digoxin immune Fab.
How the NCLEX turns the digoxin level into a question
Priority check the apical pulse and the potassium along with the level; hold and notify for a level above 2, a pulse under 60, or toxicity signs.
Lab digoxin 0.8 to 2 ng/mL and potassium 3.5 to 5.0.
Teach keep your lab appointments to check the level and potassium, and report nausea, loss of appetite, or seeing yellow halos.
A digoxin level of 1.6 ng/mL with a potassium of 3.1. Recognize that the low potassium can still cause toxicity; hold and notify even though the level looks normal.
Quick answers
What is a therapeutic digoxin level?
0.8 to 2 ng/mL. A level above 2 ng/mL is toxic.
Can digoxin be toxic at a normal level?
Yes. A low potassium (under 3.5) can cause toxicity even when the digoxin level is within range, which is why potassium is checked alongside the level.
What do you do for a high digoxin level?
Hold the dose, take an apical pulse for a full minute, notify the provider, and anticipate digoxin immune Fab (DigiFab) for serious toxicity.
Keep studying
These pages build on each other. Work through the related classes, then pressure-test yourself against the free cheat sheet and the full guide.
Digoxin patient teaching
Pulse-taking, toxicity signs, never double up.
Read the guide →Hypokalemia
Safe potassium replacement: never IV push, ECG, digoxin link.
Read the guide →ACE inhibitor cough
Bradykinin cough, and switching to an ARB.
Read the guide →Acetaminophen antidote
Acetylcysteine, the 4 gram cap, hidden sources.
Read the guide →All high-yield drug classes
The seven most-tested classes on one page, each decoded the same way.
Open the overview →Antidotes & lab values cheat sheet
The must-know antidotes, drug levels, and lab cutoffs, free and printable.
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Every high-yield class, decoded the same way
You just read the the digoxin level breakdown. The full guide runs all 54 high-yield drug classes on one repeatable system, then closes with the cram tables: antidotes, therapeutic drug levels, must-know lab values, the suffix sheet, and a final-week checklist.
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