ReviewFrontiers in cardiovascular medicine2023
Review: Failure of current digoxin monitoring for toxicity: new monitoring recommendations to maintain therapeutic levels for efficacy.
Review in Frontiers in cardiovascular medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Digoxin Derivative BD-8 Attenuates Oxidative Stress and Neuroinflammation in an LPS-Induced Experimental Model.Cell biochemistry and biophysics · 2026Article
- Digoxin Dosing Errors, Drug Interactions and Off-Label Risks: Insights from an EudraVigilance Disproportionality Analysis.Journal of clinical medicine · 2026Article
- Effect of Formulation and Process Variables on the Stability and Quality Attributes of Digoxin Formulations.Pharmaceuticals (Basel, Switzerland) · 2026Article
- An analysis of digoxin serum concentrations and influencing factors: A cross-sectional study from a tertiary hospital in China.Medicine · 2026Article
- When herbal supplements cause heart problems: Clinical case report and forensic toxicological analysis.Toxicology reports · 2026Article
- Advancing Real-World Evidence Generation: Growth and Lessons Learned from the Early Years of Cosmos.ACI open · 2026Review
- Reconsidering Digoxin in Atrial Fibrillation: From Historical Controversy to Physiologically Guided and Personalized Rate Control.Biomedicines · 2025Review
- Cognitive impairment and risk of dementia in heart failure: the exuberating role of digoxin.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Anticoagulation Therapies and microRNAs in Heart Failure.Biomolecules · 2025Review
- New Monitoring Recommendations for Digoxin During the Last Decade Are Associated With Decreased Serum Digoxin Concentrations in Patient Samples.Basic & clinical pharmacology & toxicology · 2025Article
- Drug-Induced Complete Atrioventricular Block in an Elderly Patient: A Case Report Highlighting Digoxin-Beta Blocker Interactions and a Paradoxical State.Life (Basel, Switzerland) · 2025Article
- Integral approach to organelle profiling in human iPSC-derived cardiomyocytes enhancesFrontiers in toxicology · 2025Article
- Falling into complexity: A case of digitalis-induced fall, trauma, symptomatic bradycardia, and syncope.Journal of family medicine and primary care · 2024Article
- Identification and characterization of critical values in therapeutic drug monitoring: a retrospective analysis.Scientific reports · 2024Article
- A Comprehensive Review on Unveiling the Journey of Digoxin: Past, Present, and Future Perspectives.Cureus · 2024Review
- Safety profile of intravenous digoxin in Chinese patients with acute heart failure with reduced ejection fraction: a small-scale prospective cohort study.Frontiers in pharmacology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The current recommendations for monitoring digoxin, a narrow therapeutic index drug, are limited to confirming medication use or investigating suspicion of toxicity and fail our oath to do no harm. Numerous meta-analyses evaluating digoxin use consistently recommend frequent monitoring to maintain the level of 0.5 to ≤1.0 ng/ml because higher levels lead to increased morbidity and mortality without benefit. Data from the United States National Poison Control Center (2012-2020) show annual deaths due to digoxin of 18-36 compared to lithium's 1-7, and warfarin's 0-2 respectively. The latter drugs also have narrow therapeutic indexes like digoxin yet are more carefully monitored. Recognition of digoxin toxicity is impaired as levels are not being routinely checked after medications are added to a patient's regimen. In addition, providers may be using ranges to guide treatment that are no longer appropriate. It is imperative that monitoring guidelines and laboratory therapeutic levels are revised to reduce morbidity and mortality due to digoxin. In this review, we provide a comprehensive literature review of digoxin monitoring guidelines, digoxin toxicity, and evidence to support revising the ranges for serum digoxin monitoring.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.