Pharmacokinetics of digoxin-specific Fab: effects of decreased renal function and age.
OBJECTIVE
To study the influence of age and renal function on digoxin-specific Fab (DS-Fab) pharmacokinetics.


METHODS
Sixteen patients (35-91 years) with creatinine clearance ranging from 10.6 to 122.1 ml min(-1) who had been admitted to hospital with severe digoxin or digitoxin self-poisoning were treated with DS-Fab (80 to 800 mg). Plasma DS-Fab concentrations were determined by radioimmunoassay.


RESULTS
The mean (s.d.) distribution and elimination half-lives, apparent volume of distribution and total body clearance were 1.1 +/- 0.4 h, 20.2 +/- 7.3 h, 13.1 +/- 5.8 l, and 17.6 +/- 10.8 ml min(-1), respectively. Interindividual variability of DS-Fab total body clearance was linked linearly with the decrease in creatinine clearance or with the increase in age and DS-Fab distribution volume was not dependent on creatinine clearance or age.


CONCLUSIONS
The data suggest that DS-Fab should be given to elderly and renal-impaired patients at doses similar to those given to younger or normal renal function patients.
Renard
C
C
Institut National de la Santé et de la Recherche Médicale U26, Hôpital Fernand Widal, Paris, France.
Grene-Lerouge
N
N
Beau
N
N
Baud
F
F
Scherrmann
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D019540:Area Under Curve; D004077:Digoxin / Q000276:immunology*; D005260:Female; D006207:Half-Life; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000378:metabolism* / Q000627:therapeutic use; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000139:chemically induced; D014018:Tissue Distribution
D007140:Immunoglobulin Fab Fragments; C050199:digoxin antibodies Fab fragments; D004077:Digoxin