Passage of Digoxin into Cerebrospinal Fluid in Man

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Abstract
Digoxin passage into the cerebrospinal fluid CSF was studied in 8 infants on maintenance therapy with digoxin, 11 adult patients on long-term digoxin therapy and 15 patients, previously non-digitalized, who were given 0.5 mg digoxin orally 1 h-12 h prior to lumbar puncture. Serum and CSF digitonin levels were determined by radioimmunoassay. In infants a mean serum concentration of 1.5 ng/ml (range 0.7-2.3 ng/ml) was found and a simultaneous mean CSF concentration of 0.5 ng/ml (range 0.3-1.1 ng/ml). In adults on long-term therapy, corresponding figures were 1.1 ng/ml (range 0.5-2.2 ng/ml) and 0.3 ng/ml (range 0-0.6 ng/ml). Among 15 patients given a single oral dose, detectable CSF concentrations (0.2-0.3 ng/ml) were found in five 1-12 h after drug administration. In 3 pediatric patients with hydrocephalus (3 mo.-5 yr) digoxin therapy was started as an attempt to decrease CSF production; production of CSF was reduced by 17, 25 and 30%, respectively.