Friday, April 15, 2016

IV Digoxin Loading Dose: SVT in Elderly Patients



  • No specific guidance on the dose (normal dose: 0.5 – 1mg)1
  • Consideration in elderly patients2,3:
    • Reduced volume of distribution
    • Reduced renal excretion
  • Thus, loading dose needs to be reduced. There is one reference that recommends that the dose be reduced by up to 50% in elderly patients3
  • Recommendation:
    • Loading dose should be around 0.5 – 0.75mg
    • Administer 50% initially; then may cautiously give 1/4 the loading dose q6-8hr twice; perform careful assessment of clinical response and toxicity before each dose
 References:
  1. Lexi-Comp Version 1.9.2
  2. Currie GM, Wheat JM, Kiat H. Pharmacokinetic Considerations for Digoxin in Older People.Open Cardiovasc Med J. 2011; 5: 130–135. Published online 2011 Jun 15. doi:  10.2174/1874192401105010130
  3. CANTERBURY DISTRICT HEALTH BOARD. Pharmacy Services Update DIGOXIN DOSING. Bulletin No: 2007/1

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