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Digitalis Use in Contemporary Clinical Practice:  Refitting the Foxglove

Zachary D. Goldberger, MD, MS1; G. Caleb Alexander, MD, MS2,3,4
[+] Author Affiliations
1Department of Internal Medicine, Division of Cardiology, Harborview Medical Center, University of Washington School of Medicine, Seattle
2Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
4Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland
JAMA Intern Med. 2014;174(1):151-154. doi:10.1001/jamainternmed.2013.10432.
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Over 200 years after William Withering wrote the classic monograph, An Account of the Foxglove and Some of Its Medicinal Uses,1 the indications for and optimal dosing of digitalis glycosides (primarily prescribed as digoxin) continue to be debated. Convincing evidence regarding the purported benefits of digoxin was unavailable until the Digitalis Investigation Group (DIG) trial, published in 1997.2 This study was approved by the institutional review board at each participating center.

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Digoxin Treatment Visits

Annual treatment visits with digoxin (A) and digoxin for heart failure (B) in the United States, 1997 to 2012. Source: IMS National Disease and Therapeutic Index, January 1997 to December 2012 (IMS Health Incorporated).

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