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. PubMed, 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.