Digoxin Loading Dose Calculator
Here’s a comprehensive table summarizing the key information about digoxin loading doses:
| Aspect | Details |
|---|---|
| IV Loading Dose | 500 mcg; followed by 250 mcg 6 hours later, then another 250 mcg1 |
| Oral Loading Dose | 500-750 mcg in 2 doses, 6 hours apart (max 1500 mcg in 24 hours)1 |
| Maintenance Dose | 62.5 mcg – 250 mcg daily1 |
| Duration | Administered in divided doses, typically over 4-8 hours for IV2 |
| Administration | IV infusion over 10-20 mins for parenteral, oral can be split into doses2 |
| Monitoring | Clinical response should be monitored before additional doses2 |
| Renal Adjustment | Dose adjustments for renal impairment based on GFR levels1 |
| Maximum Dose | Max oral load 1.5 mg (for IV, up to 1000 mcg)2 |
| Elderly Patients | Reduce dose in elderly or weight < 50 kg3 |
| Pediatric Dosing | Varies based on age and weight; generally requires proportionally larger doses than adults2 |
| Therapeutic Range | 0.9 to 2.0 micrograms per liter3 |
| Sampling Time | At least 6 hours post IV or PO dose, or pre-dose3 |
| Contraindications | Hypersensitivity to digoxin, sinus node disease, AV block1 |
| Bioavailability | 125 mcg tablet ≈ 125 mcg elixir ≈ 100 mcg injection3 |
| Monitoring Parameters | ECG, heart rate, blood pressure, renal function, electrolytes (especially potassium)3 |
Additional Considerations
- Route of Administration: The IV route should be reserved for urgent digitalization or when oral administration is not possible3.
- Pregnancy and Breastfeeding: Generally considered safe to use in all trimesters and during breastfeeding4.
- Factors Affecting Levels: Renal impairment, congestive heart failure, thyroid function, and interacting medications can influence serum levels3.
- Toxicity Symptoms: Nausea, vomiting, visual disturbances, arrhythmias, and bradycardia may indicate toxicity3.
- Long-term Use: Digoxin is typically prescribed for long-term use, often lifelong5.
Remember that dosing should always be individualized based on patient characteristics, clinical response, and serum digoxin levels. Regular monitoring and dose adjustments may be necessary to maintain therapeutic efficacy and minimize the risk of toxicity.