It is inherently difficult because of such components as narrow therapeutic index, difficult to define therapeutic endpoints, inter and intra-patient variability, and varying effects of pathological states and drugs on digoxin’s disposition. J Clin Pharmacol, 1974; 14:525-535.Koda-Kimble MA: Congestive heart failure, in Applied Therapeutics for Clinical Pharmacists, 2nd ed, edited by Koda-Kimble et al, Applied Therapeutics, Inc., San Francisco 1978; pp 161-86.Kramer WG, Lewis RP, Cobb TC et al: Pharmacokinetics of digoxin: comparison of a two and a three compartment model in man. Maintenance dosage is 25% to 35% of total digitalizing dose, given daily as a single dose. American College of Physicians, Philadelphia, PA, 1987.Cauffield JS, Gums JG, Grauer K. The serum digoxin concentration: ten questions to ask. There are several known attributes that have a direct correlation with the eventual therapeutic dose. Optimum dose of digoxin. American College of Physicians, Philadelphia, PA, 1987.Cauffield JS, Gums JG, Grauer K. The serum digoxin concentration: ten questions to ask. Am Fam Physician. 1994 Apr;17(2):80-6.Mooradian AD: Digitalis: An update of clinical pharmacokinetics, therapeutic monitoring techniques and treatment recommendations. After estimating the digoxin clearance, it is possible to make predictions regarding the steady state concentration:The “Jusko” Dosing section is based on the following equations.Vd = 226 + [(298 x CrCl) / (29.1 + CrCl)] x (BSA / 1.73)where A = 0.88, for patient with Acute CHF, otherwise=1These equations were provided by Rick Tharp of RXkinetics (https://www.rxkinetics.com). We comply with the HONcode standard for trustworthy health information - Clin Pharmacokinet 1988; 15:165-179. Applies to the following strengths: 250 mcg/mL (0.25 mg/mL); 50 mcg/mL (0.05 mg/mL); 100 mcg/mL (0.1 mg/mL); 125 mcg (0.125 mg); 250 mcg (0.25 mg); 500 mcg (0.5 mg); 50 mcg (0.05 mg); 100 mcg (0.1 mg); 200 mcg (0.2 mg); 62.5 mcg (0.0625 mg); 187.5 mcg (0.1875 mg)Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).For recommended maintenance doses according to lean body weight and renal function, the manufacturer product information should be consulted.This drug should be used at the lowest effective dose in order to achieve therapeutic efficacy and minimize side effects.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Maintenance dosage is 25% to 35% of total digitalizing dose, divided and given in two or three equal portions daily. Is the volume of distribution of digoxin reduced in patients with renal dysfunction? In sum, there exists significant variability as far as a given dose and concentration produced in a given patient. Additional fractions of this planned total dose may be given at 6 to 8-hour intervals, If the patient’s clinical response necessitates a change from the calculated loading dose of digoxin, then calculation of the maintenance dose should be based upon the amount actually given.A single initial dose of 500 to 750 mcg (0.5 to 0.75 mg) of digoxin tablets usually produces a detectable effect in 0.5 to 2 hours that becomes maximal in 2 to 6 hours. Clin Pharmacol Ther 1984; 36:70-73.Gilman AG, Rall TW, Nies AS et al (Eds): Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 8th ed. 1997 Aug;56(2):495-503, 509-10Cheng JW, Charland SL, Shaw LM, Kobrin S, Goldfarb S, Stanek EJ, Spinler SA. )Jusko WJ, Szefler SJ & Goldfarb AL: Pharmacokinetic design of digoxin dosage regimens in relation to renal function. J Clin Pharmacol, 1974; 14:525-535.Koda-Kimble MA: Congestive heart failure, in Applied Therapeutics for Clinical Pharmacists, 2nd ed, edited by Koda-Kimble et al, Applied Therapeutics, Inc., San Francisco 1978; pp 161-86.Kramer WG, Lewis RP, Cobb TC et al: Pharmacokinetics of digoxin: comparison of a two and a three compartment model in man.