Digitalis Body Load
Info
Select Dosing Intravenous Oral
Desired Digoxin Concentration
unit ng/ml nmol/L
Weight
unit Kgs lbs
R e s u l t s
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Digitalis body load
 
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Digitalis Body Load

The most commonly used preparation of digitalis is digoxin, which is obtained from the leaves of Digitalis lanata, a common flowering plant called "foxglove." Digitalis compounds are potent inhibitors of cellular Na + /K + -ATPase. The words digitalis and digoxin are widely used interchangeably.

While taking digoxin, it is very important that an appropriate dose be utilized as digoxin has a narrow therapeutic range (goal 0.8-2.0 ng/mL in most patients) and will usually be ineffective (<0.8) or toxic (>2.0) outside of these ranges.

The formula provided can be utilized in 2 settings:

  • Calculate how much digoxin to administer to load a patient currently not on digoxin with to achieve a desired serum level of digoxin
  • Calculate how much digoxin a patient took in overdose based upon their actual serum level to then determine how much digoxin FAB to administer (each vial binds ~0.5 mg of digoxin)

The formula:

  • DBL = Digoxin Conc*5.6*Weight/1000
  • DBL = Digitalis Body Load in mg
  • Digoxin Conc = Digoxin Concentration in ng/ml
  • The 5.6 is a volume of distribution correction factor in liters/kg Weight is in kg

An additional factor if orally dosed is the bioavailability of digoxin administered orally, which is ~0.8. So 1 mg of oral digoxin will have ~0.8 mg absorbed.

References:

  1. DigiFab TM (Digoxin Immune FAB (Ovine) FDA label. Available at http://www.fda.gov/downloads/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/FractionatedPlasmaProducts/ucm117624.pdf. Updated August, 2001. Last accessed April 26, 2013)
  2. Jelliffe RW. An improved method of digoxin therapy. Ann Intern Med . 1968;69(4):703-17.
  3. Jelliffe RW. Digitalis therapy: simple formulas to plan and adjust dosage regimens. MD Comput . 1984;2:36-43.
  4. Jelliffe RW, Buell J, Kalaba. Reduction of digitalis toxicity by computer-assisted glycoside dosage regimes. Ann Intern Med 1972;77:891-906.
  5. Hurstig MJ, Raisys VA, Opheim KE, et al. Determination of Free Digoxin Concentrations in Serum for Monitoring Fab Treatment of Digoxin Overdose. Clin Chem. 1987;33(9):1652-5.