Comparative analysis of plasma concentrations in once-a-day versus twice-a-day digoxin regimen in pediatric patients

Digoxin is a valuable drug for a variety of cardiovascular disorders but is known to have a low margin of safety. While digoxin is used in pediatric patients for several cardiac conditions, there is some controversy over the most appropriate dose and dosage regimen. These are based on presumed differences in digoxin disposition and dose response relationships in infants and children as compared to adults. Two basic differences exist in the use of digoxin in children and adults. Children receive higher daily doses (based on body weight) and commonly receive the drug as two, rather than one, daily dose. There were two objectives to this study. The primary objective was to investigate if there was a significant difference in digoxin serum concentration obtained with a once-a-day and twice-a-day dosing. A secondary objective was to evluate the relationship between serum and salivary concentrations of digoxin.