Maintenance digoxin dosage and steady-state plasma concentration in infants and children

https://doi.org/10.1016/S0022-3476(85)80636-3Get rights and content

To define the relationship between digoxin dose and plasma concentration and the changes in body growth, 1181 plasma digoxin levels were measured in 644 infants and children receiving maintenance digoxin therapy. The drug was given intravenously to 166 patients and orally to 478. A significant linear correlation between dose and plasma concentration was observed (r 0.346 to 0.767 in the intravenous and 0.264 to 0.664 in the oral groups). Dosage differences explained 7% to 60% of the variability in digoxin plasma concentrations in various age and weight groups. The linear regression slope was greater in younger age groups, especially preterm infants weighing <1500 gm, and tended to decrease with age. The data (1) allow an approximate prediction of plasma concentrations of digoxin and their variability associated with changes in dosages in various pediatric age and weight groups, (2) permit an estimate of other pharmacokinetic determinants of digoxin plasma concentration and their changes with age, and (3) suggest that larger changes in digoxin doses in older children are necessary to achieve the same change in serum concentration that is achieved with smaller dose changes in the young infant. As a result, premature infants are more sensitive to and require smaller digoxin doses.

References (21)

  • ZeegersJSW et al.

    The radioimmunoassay of plasma-digoxin

    Clin Chim Acta

    (1973)
  • ValdesR et al.

    Endogeneous substance in newborn infants causing false positive digoxin measurements

    J Pediatr

    (1983)
  • BerdeauxA et al.

    Le dosage de la digoxine plasmatique chez le nouveau-né

    Nouv Presse Med

    (1977)
  • WettrellG et al.

    Concentrations of digoxin in plasma and urine in neonates, infants and children with heart disease

    Acta Paediatr Scand

    (1974)
  • McCredieRM et al.

    Infant versus adults plasma digoxin levels

    Aust NZ J Med

    (1974)
  • WindorferA et al.

    Digoxin Serum-konzentrationen und Digitalisuberdosierung bei Neugeborenen, Sauglingen und Kleinkindern

    Z Kinderheilk

    (1974)
  • NybergL et al.

    Digoxin dosage schedules for neonates and infants based on pharmacokinetic considerations

    Clin Pharmacokinetic

    (1978)
  • NeutzeJM et al.

    Serum digoxin levels in neonates, infants and children with heart disease

    N Z Med J

    (1977)
  • Inserts: Abbott Laboratories, 125I-digoxin Imusay; Malinckrodt SPAC digoxin kit; and Kallestad Labs, Inc.,...
  • LeaheyEB et al.

    Interaction between quinidine and digoxin

    JAMA

    (1978)
There are more references available in the full text version of this article.

Cited by (19)

  • Principles of Pharmacokinetics

    2017, Fetal and Neonatal Physiology, 2-Volume Set
  • Basic Pharmacokinetic Principles

    2011, Fetal and Neonatal Physiology E-Book, Fourth Edition
  • Cardiovascular drugs for the newborn

    2005, Clinics in Perinatology
  • Basic Pharmacokinetic Principles

    2003, Fetal and Neonatal Physiology: Third Edition
View all citing articles on Scopus

Supported in part by University of Illinois Foundation Goodenberger Medical Research Grant 2-6-46856.

View full text