Safety and Efficacy of Digoxin Therapy—Where Are We Now?

The aim of our study was to determine the criteria and key factors for the effectiveness of digoxin therapy. A prospective opened-type study was carried out in conditions of everyday clinical practice. The concentrations of digoxin were quantified from blood samples taken following the achievement of drug steady-state (using AxSYM microparticle enzyme immunoassay-MEIA). The risk/benefit ratio was evaluated based upon the correlation between measured blood concentrations of the drug and clinical response. Study results (100 decompensated patients) revealed that therapy indication field was correctly covered, showing a higher prevalence in elderly. On average, each examinee had 2 or 3 comorbidities. Applied daily dose of digoxin ranged from 0.053 mg to 0.25 mg. Renal function was assessed by creatinine clearance which is one of the key factors for the accomplishment of optimal digoxin serum concentrations (p < 0.05). Co-administration of seven drugs was complicating factor for the management of rational therapy. 76/100 patients were within referent range (0.8-2.0 ng/mL), while 13/100 were above the upper limit. Four side effects in total were recorded (nausea, vomiting, confusion), whereas in only two patients digoxin was excluded from the therapy. Digoxin confirmed the justifiability of its use in contemporary clinical practice.