Digitek Dosage
Generic name: DIGOXIN 0.125mg
Dosage form: tablet
Drug classes: Group V antiarrhythmics, Inotropic agents
Medically reviewed by Drugs.com. Last updated on Feb 5, 2025.
Important Dosing and Administration Information
In selecting a digoxin dosing regimen, it is important to consider factors that affect digoxin blood levels (e.g., body weight, age, renal function, concomitant drugs) since toxic levels of digoxin are only slightly higher than therapeutic levels. Dosing can be either initiated with a loading dose followed by maintenance dosing if rapid titration is desired or initiated with maintenance dosing without a loading dose.
Consider interruption or reduction in digoxin dose prior to electrical cardioversion.
Use digoxin solution to obtain the appropriate dose in infants, young pediatric patients, or patients with very low body weight.
Loading Dosing Regimen in Adults and Pediatric Patients
For adults and pediatric patients if a loading dosage is to be given, administer half the total loading dose initially, then ¼ the loading dose every 6-8 hours twice, with careful assessment of clinical response and toxicity before each dose. The recommended loading dose is displayed in Table 1.
mcg = microgram | |
Age |
Total Oral Loading Dose (mcg/kg) |
5 to 10 years |
20-45 |
Adults and pediatric patients over 10 years |
10-15 |
Maintenance Dosing in Adults and Pediatric Patients Over 10 Years Old
The maintenance dose is based on lean body weight, renal function, age, and concomitant products.
The recommended starting maintenance dose in adults and pediatric patients over 10 years old with normal renal function is given in Table 2. Doses may be increased every 2 weeks according to clinical response, serum drug levels, and toxicity.
mcg = microgram | |
Age |
Total Oral Maintenance Dose, mcg/kg/day |
Adults and pediatric patients over 10 years |
3.4-5.1 |
Table 3 provides the recommended (once daily) maintenance dose for adults and pediatric patients over 10 years old (to be given once daily) according to lean body weight and renal function. The doses are based on studies in adult patients with heart failure. Alternatively, the maintenance dose may be estimated by the following formula (peak body stores lost each day through elimination):
- Total Maintenance Dose = Loading Dose (i.e., Peak Body Stores) x % Daily Loss/100 (% Daily Loss = 14 + Creatinine clearance/5)
Reduce the dose of DIGITEK® (digoxin tablets) in patients whose lean weight is an abnormally small fraction of their total body mass because of obesity or edema.
|
|||||||||
Corrected Creatinine Clearance† |
Lean Body Weight‡ |
Number |
|||||||
kg |
40 |
50 |
60 |
70 |
80 |
90 |
100 |
||
10 mL/min |
62.5* |
125 |
125 |
187.5 |
187.5 |
187.5 |
250 |
19 |
|
20 mL/min |
125 |
125 |
125 |
187.5 |
187.5 |
250 |
250 |
16 |
|
30 mL/min |
125 |
125 |
187.5 |
187.5 |
250 |
250 |
312.5 |
14 |
|
40 mL/min |
125 |
187.5 |
187.5 |
250 |
250 |
312.5 |
312.5 |
13 |
|
50 mL/min |
125 |
187.5 |
187.5 |
250 |
250 |
312.5 |
312.5 |
12 |
|
60 mL/min |
125 |
187.5 |
250 |
250 |
312.5 |
312.5 |
375 |
11 |
|
70 mL/min |
187.5 |
187.5 |
250 |
250 |
312.5 |
375 |
375 |
10 |
|
80 mL/min |
187.5 |
187.5 |
250 |
312.5 |
312.5 |
375 |
437.5 |
9 |
|
90 mL/min |
187.5 |
250 |
250 |
312.5 |
375 |
437.5 |
437.5 |
8 |
|
100 mL/min |
187.5 |
250 |
312.5 |
312.5 |
375 |
437.5 |
500 |
7 |
Maintenance Dosing in Pediatric Patients Less Than 10 Years Old
The starting maintenance dose for heart failure in pediatric patients less than 10 years old is based on lean body weight, renal function, age, and concomitant products. The recommended starting maintenance dose for pediatric patients between 5 years and 10 years old is given in Table 4. These recommendations assume the presence of normal renal function.
Age |
Oral Maintenance Dose, |
5 years to 10 years |
3.2-6.4 Twice daily |
Table 5 provides average daily maintenance dose requirements for pediatric patients between 5 and 10 years old (to be given twice daily) with heart failure based on age, lean body weight, and renal function.
|
|||||||||
Corrected |
Lean Body Weight |
Number of Days |
|||||||
kg |
20 |
30 |
40 |
50 |
60 |
||||
10 mL/min |
- |
62.5 |
62.5* |
125 |
125 |
19 |
|||
20 mL/min |
62.5 |
62.5 |
125 |
125 |
125 |
16 |
|||
30 mL/min |
62.5 |
62.5* |
125 |
125 |
187.5 |
14 |
|||
40 mL/min |
62.5 |
62.5* |
125 |
187.5 |
187.5 |
13 |
|||
50 mL/min |
62.5 |
125 |
125 |
187.5 |
187.5 |
12 |
|||
60 mL/min |
62.5 |
125 |
125 |
187.5 |
250 |
11 |
|||
70 mL/min |
62.5 |
125 |
187.5 |
187.5 |
250 |
10 |
|||
80 mL/min |
62.5* |
125 |
187.5 |
187.5 |
250 |
9 |
|||
90 mL/min |
62.5* |
125 |
187.5 |
250 |
250 |
8 |
|||
100 mL/min |
62.5* |
125 |
187.5 |
250 |
312.5 |
7 |
Monitoring to Assess Safety, Efficacy, and Therapeutic Blood Levels
Monitor for signs and symptoms of digoxin toxicity and clinical response. Adjust dose based on toxicity, efficacy, and blood levels.
Serum digoxin levels less than 0.5 ng/mL have been associated with diminished efficacy, while levels above 2 ng/mL have been associated with increased toxicity without increased benefit.
Interpret the serum digoxin concentration in the overall clinical context, and do not use an isolated measurement of serum digoxin concentration as the basis for increasing or decreasing the DIGITEK® (digoxin tablets) dose. Serum digoxin concentrations may be falsely elevated by endogenous digoxin-like substances. If the assay is sensitive to these substances, consider obtaining a baseline digoxin level before starting DIGITEK® (digoxin tablets) and correct post-treatment values by the reported baseline level.
Obtain serum digoxin concentrations just before the next scheduled DIGITEK® (digoxin tablets) dose or at least 6 hours after the last dose. The digoxin concentration is likely to be 10-25% lower when sampled right before the next dose (24 hours after dosing) compared to sampling 8 hours after dosing (using once-daily dosing). However, there will be only minor differences in digoxin concentrations using twice daily dosing whether sampling is done at 8 or 12 hours after a dose.
Switching from Intravenous Digoxin to Oral Digoxin
When switching from intravenous to oral digoxin formulations, make allowances for differences in bioavailability when calculating maintenance dosages (see Table 6).
Absolute Bioavailability |
Equivalent Doses (mcg) |
||||
DIGITEK® (digoxin tablets) |
60-80% |
62.5 |
125 |
250 |
500 |
Digoxin Intravenous Injection |
100% |
50 |
100 |
200 |
400 |
More about Digitek (digoxin)
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- During pregnancy
- Drug class: group V antiarrhythmics
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