Digitek

[digoxin]

Indications & Dosage
INDICATIONS AND USAGE

Heart Failure

DIGITEK is indicated for the treatment of mild to moderate heart failure. Digoxin increases left ventricular ejection fraction and improves heart failure symptoms as evidenced by exercise capacity and heart failure-related hospitalizations and emergency care, while having no effect on mortality. Where possible, digoxin should be used with a diuretic and an angiotensin-converting enzyme inhibitor, but an optimal order for starting these three drugs cannot be specified.

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Atrial Fibrillation

DIGITEK is indicated for the control of ventricular response rate in patients with chronic atrial fibrillation.

DOSAGE AND ADMINISTRATION

General

Recommended dosages of digoxin may require considerable modification because of individual sensitivity of the patient to the drug, the presence of associated conditions, or the use of concurrent medications.

In selecting a dose of digoxin, the following factors must be considered:

1. The body weight of the patient. Doses should be calculated based upon lean (i. e., ideal) body weight.

2. The patient's renal function, preferably evaluated on the basis of estimated creatinine clearance.

3. The patient's age. Infants and children require different doses of digoxin than adults. Also, advanced age may be indicative of diminished renal function even in patients with normal serum creatinine concentration (i. e., below 1.5 mg/ dL)

4. Concomitant disease states, concurrent medications, or other factors likely to alter the pharmacokinetic or pharmacodynamic profile of digoxin (see PRECAUTIONS).

Serum Digoxin Concentrations

In general, the dose of digoxin used should be determined on clinical grounds. However, measurement of serum digoxin concentrations can be helpful to the clinician in deter-mining the adequacy of digoxin therapy and in assigning certain prob-abilities to the likelihood of digoxin intoxication. About two-thirds of adults considered adequately digitalized (without evidence of toxicity) have serum digoxin concentrations ranging from 0.8 to 2 ng/ mL. However, digoxin may produce clinical benefits even at serum concen-trations below this range.

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