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Individual dosage of digoxin in patients with heart failure

S Muzzarelli1, H Stricker, O Pfister

  • 1Cardiology Department, University Hospital Basel, and Department of Cardiology, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. muzzarellis@uhbs.ch

QJM : Monthly Journal of the Association of Physicians
|November 11, 2010
PubMed

Insights

The Konishi equation effectively calculates digoxin dosage for Caucasian heart failure patients, achieving target serum digoxin concentrations in 95% of cases. This supports its clinical use for optimizing heart failure treatment.

Area of Science:

  • Pharmacology
  • Cardiology
  • Clinical Pharmacy

Background:

  • Current heart failure (HF) guidelines recommend lower serum digoxin concentrations (SDC) (0.40-1.00 ng/ml).
  • Existing digoxin dosage equations were primarily developed for higher SDCs.
  • The Konishi equation, validated in Asians for low SDCs, needed evaluation in Caucasian populations.

Purpose of the Study:

  • To assess the Konishi equation's accuracy in Caucasian heart failure patients targeting low SDCs.
  • To compare the Konishi equation with other established digoxin dosage equations.

Main Methods:

  • A prospective, multicenter study involving 40 heart failure patients receiving digoxin.
  • Dosage calculation using the Konishi equation, with SDC measured at 1 and 6 months.
  • Monitoring patient adherence to digoxin therapy.

Main Results:

  • The Konishi equation showed a reasonable correlation between predicted and measured SDC (r=0.48; P<0.01) after excluding non-adherent patients.
  • In 95% of measurements (n=54), SDC fell within the therapeutic range when excluding poor adherence and renal function changes.
  • The Konishi equation demonstrated stronger correlation compared to Jelliffe, Koup and Jusko, and Bauman equations.

Conclusions:

  • The Konishi equation is clinically valid for determining individual digoxin dosages in Caucasian patients.
  • This equation aids in achieving target SDCs aligned with current heart failure management guidelines.
Abstract

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