Administration of Digoxin

¹ University of Southern California, School of Medicine, Los Angeles, California

Administration of digoxin to the type of patient described here requires clinical judgment plus careful adjustment of dosage to the patient's renal function and body weight. Calculated body digoxin concentrations of 0.0085, 0.013, and 0.0175 mg/kg appear to give reasonable therapeutic response for many patients. These concentrations include approximately 5, 9 and 29 percent respectively of patients with digitalis toxicity. Start with the lower concentrations if possible. Greater concentrations may be required to control ventricular rate in atrial fibrillation, though probably at an increased risk of toxicity. If other preparations such as digitoxin, digitalis leaf and lanatoside C have also been recently given, the situation is more complex, but available data permit proper replacement of one glycoside by another with a different rate of excretion if creatinine clearance is known³ and if easy access to computers (such as a time-shared terminal) is available by a telephone call to a central facility.^8,9