Introduction:

Digoxin is characterized by narrow therapeutic margin which makes its dosing difficult and monitoring of its serum levels necessary. This becomes more complex in patients with chronic nephropathy who require a greater dose adjustment.

Development of the experience:

We present the case of an 88-year-old woman admitted to our unit under treatment with oral digoxin for chronic heart failure with a regimen of 1 tablet daily with rest at weekends, who presented poor symptom control and subtherapeutic serum digoxin levels in controls. Changing the formulation to pediatric oral syrup (Lanacordin® 0.05mg/mL) resulted in better drug levels and symptom control.

Conclusions:

The use of digoxin in oral syrup may be an alternative to tablet formulation, especially in patients in whom drug level control may be complex due to their comorbidities.

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