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Serum digoxin concentrations in a representative digoxin-consuming adult population
European Journal of Clinical Pharmacology
|January 1, 1985
Summary
Serum digoxin levels in adults showed wide variation but were predictable over time. Digoxin concentration correlated with dose, with older individuals and those on triamterene diuretics exhibiting higher levels.
Area of Science:
- Pharmacology
- Clinical Chemistry
- Geriatrics
Background:
- Digoxin is a crucial medication for heart failure and arrhythmias.
- Understanding factors influencing serum digoxin concentration is vital for safe and effective therapy.
- Population-based studies on digoxin levels are essential for therapeutic drug monitoring.
Purpose of the Study:
- To investigate serum digoxin concentrations in a representative adult population.
- To identify factors affecting digoxin levels, including dose, age, sex, and concomitant medications.
- To assess the reproducibility and influencing factors of digoxin measurements.
Main Methods:
- Serum digoxin concentration measurement in 661 adult patients on continuous digoxin therapy.
- Analysis of demographic data (age, sex) and medication use (digoxin dose, diuretics, triamterene).
- Repeated measurements to assess correlation and evaluation of blood collection timing effects.
Main Results:
- Mean daily digoxin dose was higher in men than women and decreased with age.
- Mean serum digoxin concentration showed no significant difference between sexes or age groups, but older individuals tended to have higher levels.
- Approximately 60% of patients had concentrations within the therapeutic range (0.80-2.00 ng/ml).
- Serum digoxin concentration was strongly related to the daily dose, with higher levels in older individuals at equal doses.
- Concomitant triamterene use, especially with thiazide or loop diuretics, significantly increased serum digoxin concentration.
- High interindividual variation in serum digoxin levels was observed, but repeated measurements showed good correlation.
Conclusions:
- Serum digoxin concentrations are closely related to prescribed dosage and influenced by age and triamterene use.
- Wide interindividual variability necessitates careful therapeutic drug monitoring.
- Triamterene may interact with digoxin, potentially increasing serum concentrations and risk of toxicity.