alexa Population Pharmacokinetics and Optimization of the Dos
ISSN: 2376-0419

Journal of Pharmaceutical Care & Health Systems
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Research Article

Population Pharmacokinetics and Optimization of the Dosing Regimen of Digoxin in Adult Patients

Toshiaki Komatsu1*, Mami Morita1, Futaba Miyaji1, Takayuki Inomata2, Junya Ako2 and Koichiro Atsuda1
1Department of Pharmacy, Kitasato University Hospital, Sagamihara, Japan
2Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
Corresponding Author : Toshiaki Komatsu
Department of Pharmacy, Kitasato University Hospital
1-15-1 Kitasato, Minami-Ku, Sagamihara
Kanagawa 252-0375, Japan
Tel: +81-42-778-8123
Fax: +81-42-8650; E-mail: [email protected]
Received: October 16, 2015; Accepted: November 04, 2015; Published: November 10, 2015
Citation: Komatsu T, Morita M, Miyaji F, Inomata T, Ako J, et al. (2015) Population Pharmacokinetics and Optimization of the Dosing Regimen of Digoxin in Adult Patients. J Pharma Care Health Sys 2:147. doi:10.4172/2376-0419.1000147
Copyright: © 2015 Komatsu T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Background: This study aimed to evaluate the population pharmacokinetics of digoxin in Japanese patients and establish a dosage regimen based on the pharmacokinetic data. Methods: We analyzed 287 serum digoxin samples from 192 individuals by using the nonlinear mixed effects model. We used simulations to optimize the dosage regimen of digoxin to achieve a high likelihood of the target concentration (0.5-0.8 ng/mL). Results: The total body clearance (CL/F ([L/h]) was calculated using the following formula: CL/F=(1.21+0.0532 × CLcr [(mL/min]) × (1+0.787 × AMD), where CLcr is the creatinine clearance and AMD is 0 in the case of concomitant administration of amiodarone and 1 otherwise. To achieve the target concentration (0.5–0.8 ng/mL), the dosage of digoxin was 0.0625 mg/day (CLcr <35 mL/min and AMD=0); 0.125 mg/day (CLcr, 35–65 mL/min and AMD=0); 0.1875 mg/day (CLcr, 65–100 mL/min and AMD=0); 0.0625 mg/every other day (CLcr <30 mL/min and AMD=1); and 0.0625 mg/day (CLcr, 30–85 mL/min and AMD=1). Conclusion: Our findings suggest that population parameters are useful for evaluating digoxin pharmacokinetics.

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