Population pharmacokinetics of digoxin in elderly patients: A systematic review.

OBJECTIVE

To resume the available literature about digoxin population pharmacokinetic studies in elderly patients. To identify the  pathophysiological changes in this subpopulation with clinical implications on  digoxin pharmacokinetics.

METHOD: A systematic review was performed regarding the population pharmacokinetic studies in elderly patients receiving digoxin. Pub-Med, ISI Web of Science, SCOPUS and Science Direct were used to identify the articles with the descriptors ("Digoxin"[Mesh]) AND ("Pharmacokinetics"[Mesh]) AND ("Aged"[Mesh] OR "Elderly"[Mesh]), followed by a manual search.

RESULTS

Nine studies were found and reviewed, five of them carried out in  Asian patients. NONMEM was used for pharmacokinetic analysis of digoxin  blood levels, being mostly described by a one-compartment model. Serum  creatinine, body weight and concomitant administration of calcium channel  blockers are the covariates that most frequently influence digoxin  pharmacokinetics in elderly patients.

CONCLUSIONS

Elderly people present pathophysiological changes with influence  on the pharmacokinetics of many drugs. The covariates with most influence on digoxin pharmacokinetics should be considered when adjusting this drug dosage in elder patients to achieve optimum health benefits and prevent possible side effects.