The maintenance dose of digoxin

Slow digitalization: Here maintenance dose of Digoxin (average 0.25 mg/day) is given from the beginning. Full response takes 5-7 days to develop, but the procedure is much safer. In case an adequate response is not seen after I week, increase the dose to 0.375 and then to 0.5 mg after another week.Rapid oral digitalization: Here Digoxin 0.5 - 1.0 mg stat dose given followed by 0.25 mg every 6 hours with careful monitoring and watch for toxicity till response occurs - generally takes 6-24 hours (total dose 0.75 - 1.5 mg). This is seldom practised now.Emergency digitalization: It is practised rarely now, only as a desperate measure in CHF or in atrial fibrillation. Digoxin 0.25 mg followed 0.1 mg hourly is given by slow IV. Injection with close ECG, BP and CVP monitoring till response occurs (2-6 hours, total dose 0.5 - 1.0 mg)