Therapeutic monitoring of serum digoxin for patients with heart failure using a rapid LC-MS/MS method

Clin Biochem. 2010 Feb;43(3):307-13. doi: 10.1016/j.clinbiochem.2009.09.025. Epub 2009 Oct 13.

Abstract

Objective: Here we develop a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the determination of digoxin in serum.

Design and methods: The serum samples were extracted with methyl tert-butyl ether using an isotope-labeled digoxin-d3 as internal standard. The analyte was separated on a reverse phase Capcell C18 column and detected in positive electrospray ionization multiple reaction monitoring mass spectrometry.

Results: The chromatographic analysis was carried out within 3 min, but the complete analysis took longer because of the liquid-liquid extraction. The lower limit of quantification was 0.1 ng/mL for digoxin. The intra- and inter-batch precisions were less than 12%, and the bias ranged from -9.1% to 10.7%. The external quality assessment (EQA) results obtained with the LC-MS/MS method were comparable to target values. Subsequently, this method has been applied to the therapeutic monitoring of digoxin in a clinical setting.

Conclusion: In this study, we have developed a rapid and reliable LC-MS/MS method for the therapeutic monitoring of digoxin in human serum.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chromatography, Liquid / methods*
  • Digoxin / blood*
  • Digoxin / therapeutic use
  • Heart Failure / blood*
  • Heart Failure / drug therapy
  • Humans
  • Molecular Structure
  • Quality Control
  • Reproducibility of Results
  • Tandem Mass Spectrometry / methods*

Substances

  • Digoxin