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Original Research |

An Improved Method of Digitoxin Therapy

ROGER W. JELLIFFE, M.D., F.A.C.P.; JUNE BUELL, B.A.; ROBERT KALABA, PH.D.; R. SRIDHAR, PH.D.; RICHARD ROCKWELL, B.A.; and JOHN G. WAGNER, PH.D.
[+] Article and Author Information

Supported by grants HE 07197, HE 90428, HE 11475, Fr-43, GM-14633, and GM-16197, U. S. Public Health Service, Washington, D. C.; and by the Los Angeles, Orange, Santa Barbara, and Fresno County Heart Associations.

▸Requests for reprints should be addressed to Roger W. Jelliffe, M.D., 2025 Zonal Ave., Los Angeles, Calif. 90033


Los Angeles, California; and Ann Arbor, Michigan


Ann Intern Med. 1970;72(4):453-464. doi:10.7326/0003-4819-72-4-453
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An improved method of digitoxin therapy is presented for adult euthyroid patients of average weight with normal hepatic function, electrolyte balance, and gastrointestinal absorption whose renal function may be normal, reduced, or changing. The method uses a loading dose of 0.8 to 1.4 mg of United States Pharmacopeia (USP) digitoxin in three divided doses 6 hr apart. The proper maintenance dose depends on renal function. Reasonable estimates of it are found from graphs and simple equations presented. In 95% of patients the maintenance dose should sustain body glycoside stores at 73 to 150% of the selected level when renal function is normal and from 73 to 133% in anuric patients. Caution is urged when raising body glycoside stores above 1.4 mg, though this may be necessary to control ventricular rate when atrial arrhythmias are present.

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digitoxin

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