Comparing the toxicity of digoxin and digitoxin in a geriatric population: should an old drug be rediscovered?
BACKGROUND
Little information is available regarding toxicity rates of the two available forms of cardiac glycosides (digoxin, digitoxin) when used in elderly patients.


METHODS
We retrospectively analyzed the charts of all patients more than 60 years of age who were chronically managed with a cardiac glycoside and were hospitalized during the period January 1995 through January 1998. Toxicity was defined as any clinical event that required either a reduction in dose of the drug or its discontinuance.


RESULTS
Toxicity occurred among 7.6% of hospitalizations in which digitoxin was used, compared with 18.3% of hospitalizations in which digoxin was used. In multivariate analysis, the odds of toxicity adjusted for other clinical characteristics were three times greater for patients taking digoxin than for patients taking digitoxin.


CONCLUSIONS
Hospitalized elderly patients taking digitoxin had a lower rate of toxicity than those taking digoxin.
Roever
C
C
Department of Family Medicine, University of South Florida and the H. Lee Moffitt Cancer Center and Research Institute, Tampa 33612, USA.
Ferrante
J
J
Gonzalez
E C
EC
Pal
N
N
Roetzheim
R G
RG
D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000009:adverse effects*; D004074:Digitoxin / Q000009:adverse effects*; D004077:Digoxin / Q000009:adverse effects*; D005260:Female; D005431:Florida; D005853:Geriatrics; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D002316:Cardiotonic Agents; D004077:Digoxin; D004074:Digitoxin