Digitoxin

General Toxicity Notes
Add to uremic gastrointestinal symptoms. Toxicity enhanced by hypokalemia and hypomagnesemia during dialysis.
Excreted Unchanged %
20-25
Half-Life (Normalesrd) Hours
144-200/210
Plasma Protein Binding %
94
Volume Of Distribution L/Kg
0.6
Dose For Normal Renal Function
0.1-0.2 mg q24h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50-75% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,monitor serum concentration, [D]
References
Kelly RA, Smith TW. Use and misuse of digitalis blood levels. Heart Dis Stroke. 1992; 1: 117-22. [PMID: 1344095] / V&#246; hringer HF, Rietbrock N. Digitalis therapy in renal failure with special regard to digitoxin. Int J Clin Pharmacol Ther Toxicol. 1981; 19: 175-84. [PMID: 7021432]
Toxicity Notes
Increased conversion to digoxin in ESRD (8-10% conversion in normals). Vd decreased by uremia.