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9 of patients in the placebo arm were suspected of having digoxin toxicity, the most common symptoms being new episodes of ventricular fibrillation, supraventricular arrhythmia, tachycardia, or advanced atrioventricular block.
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monitor digoxin levels when initiating, adjusting, and discontinuing diltiazem therapy to avoid possible over-or under-digitalization see warnings and precautions .
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digoxin is known to slow heart rates and potentiate bradyarrhythmias 25 through its parasympathetic effect on the av node, but has little effect on fast ventricular rates in the setting of enhanced sympathetic tone.
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patients taking digoxin should be monitored appropriately when simvastatin is initiated see clinical pharmacology .
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