Digoxin Dosing and the Risk of Toxicity in Older Adults With CKD

Digoxin, commonly used to treat heart failure,1,2 has a narrow therapeutic range and is eliminated primarily by the kidney.1 To avoid toxicity, digoxin should be started at ≤0.125 mg/day in patients with chronic kidney disease (CKD) (Table S1).1,2 In review of the literature, we found that studies examining digoxin toxicity in patients with CKD were limited to case reports or focused on patients receiving dialysis (Tables S2 and S3). We aimed to address this knowledge gap by conducting a population-based study of older adults with CKD newly prescribed digoxin.