BIOAVAILABILITY AND ELIMINATION OF DIGITOXIN IN PATIENTS WITH HEPATORENAL INSUFFICIENCY

Following administration of digitoxin, 1 mg intravenously, the pharmacokinetics of the glycoside were studied in eight healthy volunteers and in eight patients with hepatorenal insufficiency (mean creatinine clearance 19.6 .+-. 2.9 ml/min; antipyrine clearance 25.6 .+-. 3.2 ml/min; .hivin.X .+-. SEM). Liver cirrhosis of the patients was confirmed by liver biopsy. Plasma protein binding of digitoxin (.hivin.X .+-. /SEM) was 95.1 .+-. 0.7% in the patients and 95.6 .+-. 1.2% in the volunteers (NS). Total body clearance of digitoxin was 0.0530 .+-. 0.0040 ml/min/kg of body weight in the patients and 0.0547 .+-. 0.0043 ml/min/kg of body weight in the health subjects (NS). When elimination half-lives of the patients and the volunteers were compared, there was also no significant difference (7.0 .+-. 0.77 days in the patient group and 7.8 .+-. 0.8 days in the volunteers). Our data concerning digitoxin kinetics in patients with hepatorenal insufficiency do not indicate an accumulation of the drug in these patients.