Could digoxin treat tachyarrhythmias in severe methylxanthine overdose?

Caffeine and theophylline use can lead to methylxanthine toxicity, resulting in life-threatening tachyarrhythmias and hypotension. Esmolol, a beta-adrenergic antagonist, is a suggested option for controlling associated tachyarrhythmias. However, esmolol is not universally available, and its hypotensive effects often deter its use. Digoxin, another rate control agent which is widely available, theoretically possesses the circulatory system effects needed to tackle both tachyarrhythmia and hypotension induced by methylxanthine toxicity. We propose digoxin as an alternative to esmolol, especially in regions where esmolol is unavailable and for individuals experiencing hypotension due to methylxanthine toxicity.