Digoxin (Lanoxin); Cardiac Glycoside; Cap: 50, 100, 200 mcg
Elixir: 50 mcg/mL [60 mL]
Inj: 100, 250 mcg/mL
Tab: 125, 250, 500 mcg;
Digoxin Total Digitalizing Dose:
Preterm: 15-30 mcg/kg
IV; 20-30 mcg/kg PO
Term 0-4 wk: 20-30 mcg/kg
IV; 25-35 mcg/kg PO
1-23 mos: 30-50 mcg/kg
IV; 40-50 mcg/kg PO
2-4.99 yrs: 25-35 mcg/kg
IV; 30-40 mcg/kg PO
5 yrs-10 yrs: 15-30 mcg/kg
IV; 20-35 mcg/kg PO
11-17 yrs: 8-12 mcg/kg
IV; 10-15 mcg/kg PO
>18 yrs: 0.5-1 mg
IV; 0.75-1.5 mg PO
Give 1/2 total dose initially, then 1/4 of dose q8-12h x 2 doses (EKG 2h before each dose).
Max total digitalizing dose: 1000 mcg
IV, 1500 mcg PO
Digoxin Maintenance Dose: Preterm: 4-9 mcg/kg/day
IV; 4-12 mcg/kg/day PO
Term 0-2 wk: 6-8 mcg/kg/day
IV; 6-10 mcg/kg/day PO
2 wk-2 yrs: 8-10 mcg/kg/day
IV; 10-15 mcg/kg/day PO
2 yrs-5 yrs: 6-8 mcg/kg/day
IV; 8-10 mcg/kg/day PO
5 yrs-10 yrs: 4-8 mcg/kg/day
IV; 5-10 mcg/kg/day PO
>10 yrs: 2-3 mcg/kg/day
IV; 2.5-5 mcg/kg/day PO
Maximum daily maintenance dose: 500 mcg PO, 400 mcg
IV Divide
IV maintenance doses bid. Divide oral doses bid if <10 yrs and qd if >10 yrs.
Low
serum potassium or magnesium potentiates
toxicity. Reduce dose in
renal failure.
Toxicity is indicated by nausea, vomiting, headache, visual
disturbances (yellow-green halos around lights), arrhythmias.