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Pharmacokinetics of digoxin-specific Fab: effects of decreased renal function and age
C Renard1, N Grene-Lerouge, N Beau
1Institut National de la Santé et de la Recherche Médicale U26, Hôpital Fernand Widal, Paris, France.
Aims:
To study the influence of age and renal function on digoxin-specific Fab (DS-Fab) pharmacokinetics.
Methods:
Sixteen patients (35-91 years) with creatinine clearance ranging from 10.6 to 122.1 ml min(-1) who had been admitted to hospital with severe digoxin or digitoxin self-poisoning were treated with DS-Fab (80 to 800 mg). Plasma DS-Fab concentrations were determined by radioimmunoassay.
Results:
The mean (s.d.) distribution and elimination half-lives, apparent volume of distribution and total body clearance were 1.1 +/- 0.4 h, 20.2 +/- 7.3 h, 13.1 +/- 5.8 l, and 17.6 +/- 10.8 ml min(-1), respectively. Interindividual variability of DS-Fab total body clearance was linked linearly with the decrease in creatinine clearance or with the increase in age and DS-Fab distribution volume was not dependent on creatinine clearance or age.
Conclusions:
The data suggest that DS-Fab should be given to elderly and renal-impaired patients at doses similar to those given to younger or normal renal function patients.