Dosing methods for digoxin, a drug used to treat heart failure, have not been updated in decades despite evidence in recent years suggesting that blood levels of digoxin achieved with traditional dosing practices may increase the risk of adverse events. We developed a simple dosing tool that targets lower blood levels of digoxin that have been associated with improved outcomes compared to higher blood levels. The aim of this study is to determine if this simplified dosing tool is more effective than standard digoxin dosing practices at achieving lower blood levels and also to determine if digoxin dosing may be further optimized by incorporating patients' genetic information believed to influence the drug's properties.
Name: Digoxin Dosing per Nomogram
Description: Simplified dosing nomogram for digoxin. The dose is determined by plotting a subject's creatinine clearance (x-axis) and ideal body weight (y-axis) on the nomogram. Alternatively, the dose may be determined by plotting creatinine clearance (x-axis) and gender/height (z-axis).Type: OtherDigoxin Dosing per Nomogram
Name: Digoxin
Description: All patients included in the trial were treated with digoxin as clinically indicated. The intervention for this study required determining the digoxin dose via a proposed nomogram.Type: DrugDigoxin Dosing per Nomogram Standard Digoxin Dosing
Description: 55 patients in the Digoxin Dosing per Nomogram group consented to the Pharmacogenetic substudy and provided blood samples to perform pharmacogenetic analyses. We compared serum digoxin concentrations by ABCB1 genotype.
Measure: Serum Digoxin Concentration by ABCB1 Single Nucleotide Polymorphism (SNP) C1236T Time: Steady-state (2 - 4 weeks after initiation)Description: Serum digoxin concentration by genotypes for the ABCB1 SNP C3435T
Measure: Serum Digoxin Concentration by ABCB1 SNP C3435T Time: Steady-state (2 - 4 weeks after initiation)Description: Serum digoxin concentration by ABCB1 SNP genotypes
Measure: Serum Digoxin Concentration by ABCB1 SNP G2677T/A Time: Steady-state (2 - 4 weeks after initiation)Allocation: Non-Randomized
Parallel Assignment
There are 3 SNPs
Serum Digoxin Concentration by ABCB1 Single Nucleotide Polymorphism (SNP) C1236T. --- C1236T ---
We compared serum digoxin concentrations by ABCB1 genotype.. Serum Digoxin Concentration by ABCB1 SNP C3435T. --- C3435T ---
Serum digoxin concentration by genotypes for the ABCB1 SNP C3435T. --- C3435T ---
Serum Digoxin Concentration by ABCB1 SNP G2677T/A. --- G2677T ---