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Creatinine decreases renal excretion, hence target ranges apply. The greater the hypokalaemia the greater the associated toxicity, there is no threshold, but 3.0 mmol/L would not be unreasonable. Ian Dr Ian D Watson Clinical Director, Clinical Laboratories Consultant Biochemist & Toxicologist Dept Clinical Biochemistry University Hospital Aintree Lower Lane Liverpool L9 7AL Tel +44 151 529 3575 Fax +44 151 529 3310 -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ginny Lee Sent: 22 June 2011 12:51 To: [log in to unmask] Subject: Re: Digoxin We have decided to ammend our digoxin comment to: "The target range for digoxin is 0.5-1.0 ug/L for patients being treated for heart failure. However, a range of 0.5-2.0 ug/L may be appropriate for some patients. There is an increased risk of digoxin toxicity, even if the level is within the therapeutic range, if there is hypokalaemia or renal impairment" At what potassium and creatinine levels should we start to think about toxicity occuring within the therapetic range? Thanks Ginny Dr Virginia Lee, PhD, FRCPath Senior Clinical Scientist Department of Chemical Pathology Level 4 Sandringham Building Leicester Royal Infirmary Leicester LE1 5WW Tel: 0116 2586560 Fax: 0116 2586550 ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/