Population analysis for the optimization of digoxin treatment in Japanese paediatric patients.
OBJECTIVE
Information about the pharmacokinetics of digoxin in paediatric patients is limited. We therefore aimed to investigate the effects of physiological factors on the digoxin clearance in Japanese paediatric patients.


METHODS
We used routinely collected therapeutic drug monitoring data (n=544), derived from the steady-state serum concentrations of digoxin in 181 hospitalized paediatric patients.


RESULTS
Of those physiological factors which have been examined in this study, age and total body weight were most closely correlated with digoxin clearance. Data on neonates within the first postnatal month indicated a tendency towards lower clearance for premature neonates than full-term neonates (P<0.01). Digoxin clearance was reduced by spironolactone in patients younger than 4 months (P<0.05). Patients with congestive heart failure showed a lower digoxin clearance than the others (P<0.001). Serum creatinine and gender did not have a statistically significant effect on digoxin clearance.


CONCLUSIONS
Age and total body weight are important factors influencing digoxin clearance in children. Spironolactone affected digoxin clearance and needs to be considered when dosing paediatric subjects.
Suematsu
F
F
Department of Hospital Pharmacy, Kyushu Kousei-Nenkin Hospital, Kitakyushu, Japan.
Minemoto
M
M
Yukawa
E
E
Higuchi
S
S
D000367:Age Factors; D001835:Body Weight; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D004077:Digoxin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D004347:Drug Interactions; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012737:Sex Factors; D013148:Spironolactone / Q000493:pharmacokinetics
D002316:Cardiotonic Agents; D013148:Spironolactone; D004077:Digoxin