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Importance of Pharmacokinetics and Dosage in digoxin maintenance therapy


PH Joubert
FO Moller
DF Pansergrouw

Abstract

A retrospective analysis of serum digoxin levels in 105 patients above 16 years of age revealed that a daily maintenance dose of 0,25 mg digoxin appears to be preferable to higher doses. The incidence of therapeutic levels (8,0 - 1,8 ng/ml) did not differ significantly from that obtained with higher doses-whereas the incidence of 'toxic' levels was significantly lower with this dosage. Patients diagnosed as being digitalis-toxic or as exhibiting refractory cardiac failure on clinical grounds, had digoxin serum levels significantly higher than those found in patients with satisfactorily controlled cardiac failure but without signs of digitalis toxicity. Serum digoxin levels were significantly raised in patients with raised blood-urea. It is concluded that pharmacokinetic considerations are important in the clinical application of digoxin and that determination of serum levels is an important adjuvant in determining correct dosage in select cases.

S. Afr. Med. J., 48, 907 (1974).

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eISSN: 2078-5135
print ISSN: 0256-9574