Closing in on the ideal digoxin dosage

When treating CHF patients with digoxin, small doses are good, notes David Roffman, PharmD, BCPS, associate professor at the University of Maryland’s School of Pharmacy in Baltimore. To alleviate symptoms, 0.125 mg to 0.25 mg per day usually brings good results, even for elderly patients. Signs of toxicity are gastrointestinal distress, anorexia, nausea, and rhythm changes.

"We don’t know what the optimal dose is," adds University of Maryland cardiologist Stephen S. Gottlieb, MD. Finding the lowest dose that could still bring the benefits could help control the cases of toxicity.

(Editor’s note: For a comprehensive description of the use of digoxin in CHF patients, according to a consensus of 150 U.S. physicians, see the ACTION HF guidelines, published as a supplement to the American Journal of Cardiology in January.)