European Journal of Clinical Pharmacology

, Volume 25, Issue 1, pp 117–121 | Cite as

Pharmacokinetics of digoxin in pregnancy

  • A. M. E. Luxford
  • G. S. M. Kellaway


Digoxin-renal-clearance, creatinine-clearance, 24-h urine elimination of digoxin and serum digoxin were studied in 15 patients in the third trimester of pregnancy and 6 to 12 weeks post-partum. There was significant fall post-partum in the first three. There was also a significant fall post-partum in serum digoxin levels. This finding was unexpected, but may be due to heightened absorption exceeding increased elimination because of the physiological status in pregnancy.

Key words

serum digoxin pregnancy digoxin-renal-clearance creatinine-clearance digoxin-elimination pharmacokinetics 


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  1. 1.
    Aronson JK (1980) Clinical pharmacokinetics of digoxin. Clin Pharmacokinet 5: 137–149Google Scholar
  2. 2.
    Bloom PM, Nelp WN (1966) Relationship of the excretion of tritiated digoxin to renal function. Am J Med Sci 251: 133–144Google Scholar
  3. 3.
    Bonelli J, Haydl H, Hruby K, Kaik G (1978) The pharmacokinetics of digoxin in patients with manifest hyperthyroidism and after normalization of thyroid function. Int J Clin Pharmacol Ther Toxicol 16: 302–306Google Scholar
  4. 4.
    Cogan JJ, Humphries MH, Carlson CT, Benowitz NL, Rapaport E (1981) Acute vasodilator therapy increases renal clearance of digoxin in patients with congestive heart failure. Circulation 64: 973–976Google Scholar
  5. 5.
    Croxson MS, Ibbertson HK (1975) Serum digoxin in patients with thyroid disease. Br Med J 3: 566–568Google Scholar
  6. 6.
    Dobbs SM, Mawer GE (1977) Prediction of digoxin dose requirements. Clin Pharmacokinet 2: 281–291Google Scholar
  7. 7.
    Doherty JE, Ferrell CB, Towbin EJ (1969) Localisation of the renal excretion of tritiated digoxin. Am J Med Sci 258L: 181–189Google Scholar
  8. 8.
    Eadie MJ, Lander CM, Tyler JH (1977) Plasma drug level monitoring in pregnancy. Clin Pharmacokinet 2: 427–436Google Scholar
  9. 9.
    Ewy GA, Groves BM, Ball MF, Nimmo L, Jackson B, Marcus F (1971) Digoxin metabolism in obesity. Circulation 44: 810–814Google Scholar
  10. 10.
    Fantini F, Lucchini CR, Padeletti L, Marsilii A, Dolara P, Manelli M (1977) Digoxin and congestive cardiac failure. Acta Cardiol 32: 353–362Google Scholar
  11. 11.
    Greenblatt DJ, Smith TN, Koch-Weser J (1976) Bioavailability of drugs: The digoxin dilemma. Clin Pharmacokinet 1: 37–51Google Scholar
  12. 12.
    Hall WH, Doherty JL (1971) Gastric absorption of digoxin is of minor importance. Dig Dis Sci 16: 903–908Google Scholar
  13. 13.
    Halkin H, Steiner LB, Peck CC, Melmon KL (1975) Determinants of the renal clearance of digoxin. Clin Pharmacol Ther 17: 385–394Google Scholar
  14. 14.
    Heinz N, Rietbrock N (1979) Relationship between dose and plasma level of digoxin and patient characteristics. Eur J Clin Pharmacol 15: 109–114Google Scholar
  15. 15.
    Iisalo E (1977) Clinical pharmacokinetics of digoxin. Clin Pharmacokinet 2: 1–16Google Scholar
  16. 16.
    Jelliffe RW (1971) Factors to consider in planning digoxin therapy. J Chronic Dis 24: 407–409Google Scholar
  17. 17.
    Kauffman N, Olcay A, Schaumann W, Teufel W, Weib B (1981) Pharmacokinetics of metildigoxin and digoxin in geriatric patients with normal and elevated serum creatinine levels. Clin Pharmacokinet 6: 463–468Google Scholar
  18. 18.
    Koup KR, Jusko WJ, Elwood CM, Kohli RK (1975) Digoxin pharmacokinetics: Role of renal failure in dosage regimen design. Clin Pharmacol Ther 18: 9–21Google Scholar
  19. 19.
    Krauer B, Krauer F (1977) Drug kinetics in pregnancy. Clin Pharmacokinet 2: 167–181Google Scholar
  20. 20.
    Lindebaum J, Mellow MH, Blackstone MD, Butler VP (1971) Variation in biological availability of digoxin from four preparations. N Engl J Med 285: 1344–1347Google Scholar
  21. 21.
    Manninen V, Apajalahti, Melin J, Karesoja M (1973) Altered absorption of digoxin in patients given propantheline and metaclopramide. Lancet 1: 398–401Google Scholar
  22. 22.
    Morselli PL, Franco-Morselli R, Bossi L (1980) Clinical pharmacokinetics in newborns and infants. Clin Pharmacokinet 5: 485–527Google Scholar
  23. 23.
    Nyberg L, Wettrell G (1980) Pharmacokinetics and dosage of digoxin in neonates and infants. Eur J Clin Pharmacol 18: 69–74Google Scholar
  24. 24.
    Ochs H, Boden G, Schafer PK, Kodrat G, Dengler HJ (1975) Absorption of digoxin from the distal parts of the intestine in man. Eur J Clin Pharmacol 9: 95–97Google Scholar
  25. 25.
    Ohnhaus EE, Vozem S, Nuesch E (1979) Adsorption of digoxin in severe right heart failure. Eur J Clin Pharmacol 15: 115–121Google Scholar
  26. 26.
    Parry E, Shields R, Turnbull AC (1970) Transit time in the small intestine in pregnancy. J Obstet Gynecol Br Commonw 77: 900–901Google Scholar
  27. 27.
    Paulson MF, Wlling PG (1976) Calculation of serum digoxin levels in patients with normal and impaired renal function. J Clin Pharmacol 16: 660–665Google Scholar
  28. 28.
    Rogers MC, Willerson JT, Goldblatt A, Smith JW (1972) Serum digoxin concentrations in the human fetus, neonate and infant. N Engl J Med 287: 1010–1013Google Scholar
  29. 29.
    Shenfield GM, Thompson J, Horn DB (1971) Plasma and urine digoxin in thyroid dysfunction. Eur J Clin Pharmacol 12: 437–443Google Scholar
  30. 30.
    Steiness E (1974) Renal tubular secretion of digoxin. Circulation 50: 103–107Google Scholar
  31. 31.
    Sumner DJ, Russell AJ (1976) Digoxin pharmacokinetics: Multi-compartmental analysis and its clinical implications. Br J Clin Pharmacol 3: 221–229Google Scholar
  32. 32.
    Taggart AJ, Johnson GD, McDevett DG (1981) Does the frequency of daily dosage influence compliance in digoxin therapy? J Clin Pharmacol 1: 31–34Google Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • A. M. E. Luxford
    • 1
  • G. S. M. Kellaway
    • 1
  1. 1.Department of Pharmacology and Clinical PharmacologyUniversity of Auckland, School of MedicineAucklandNew Zealand

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