title: Digoxin: use pattern in Estonia and bioavailability of the local market leader.
abstract: BACKGROUND
  In comparison with neighbouring Scandinavian countries, the use of digoxin in Estonia is high. The present study was carried out to determine the use pattern of digoxin in Estonia and bioavailability of the local market leader preparation in comparison with Lanoxin.
  
  
  METHODS
  Drug use data were evaluated from the annual reports of wholesale companies. For the bioequivalence study, a single-blind cross-over randomised two-way single-dose comparative bioavailability study was performed using 14 healthy volunteers. Digoxin concentrations in serum samples and urine were measured by chemiluminescent competitive immunoassay.
  
  
  RESULTS
  The use of digoxin in Estonia has increased by 35% during the period 1994-97. The steady market leader was the local generic drug. No statistically significant differences were found in any pharmacokinetic parameter between the generic preparation and Lanoxin. All parameters showed considerable variability. The total amount of drug excreted was the parameter with lowest inter- individual variation.
  
  
  CONCLUSIONS
  The present study indicates that the generic digoxin preparation studied is bioequivalent to Lanoxin. The increasing use of digoxin in Estonia is not caused by low bioavailability of the local market leader but by therapeutic traditions.
authors.affiliation: Department of Pharmacoogy, University of Tartu, Estonia.
authors.forename: R
authors.initials: R
authors.lastname: Pähkla
authors.forename: A
authors.initials: A
authors.lastname: Irs
authors.forename: K
authors.initials: K
authors.lastname: Oselin
authors.forename: L
authors.initials: L
authors.lastname: Rootslane
mesh_terms: D000293:Adolescent; D000328:Adult; D001682:Biological Availability; D002316:Cardiotonic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004077:Digoxin / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004957:Estonia; D005260:Female; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D013810:Therapeutic Equivalency
chemical_list: D002316:Cardiotonic Agents; D004077:Digoxin