Some Observations on Serum Concentrations of Digitoxin and Digoxin

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Abstract
Serum concentrations of digitoxin and digoxin were measured in 145 cases with various heart diseases receiving maintenance doses of digitalis. Digitalis toxicity was seen in 2 cases (1.4%). Daily variation of serum concentration while taking the same daily dose was small in digitoxin therapy (13.8%) but a considerable variation was seen in digoxin therapy (24.4%). Serum concentrations of digitoxin and digoxin were measured in the patients receiving digitoxin and there was a positive correlation between the 2 (r [correlation coefficient] = 0.66, P < 0.001). The effect of digitoxin apparently was the sum of the effects of digitoxin and its metabolite digoxin. In the patients taking digoxin, digitoxin was not detected in the serum. Serum digitoxin level had a significantly positive correlation to serum albumin level presumably because digitoxin was retained in serum in the bound form to albumin. Minimal effective level, 10 ng/ml, was obtained with higher daily dose of digitoxin in patients with lower serum albumin.

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