Dosing recommendations for digoxin therapy
| Indication | Dosing | Desired serum concentration | Comments |
|---|---|---|---|
| Symptomatic heart failure with reduced ejection fraction despite guideline-directed medical therapy | 0.125–0.25 mg daily, modified according to nomogram of Jelliffe and Brooker6 | 0.5–0.9 ng/mL | No need for loading dose Low doses (0.125 mg daily or every other day) should be used initially if the patient is > 70 years, has impaired renal function, or has a low lean body mass |
| Rate control in atrial fibrillation with decreased left ventricular function or hemodynamic instability | Loading dose: 0.25 mg intravenously with repeat dosing every 6 hours to a maximum of 1.5 mg over 24 hours Maintenance dose: 0.125–0.25 mg daily | 0.5–1.2 ng/mL | For individuals with low body weight (45–70 kg) and renal dysfunction, loading doses should be reduced to 0.7 to 1.0 mg in the first 24 hours |
Based on information from references 3–5.