The maximum oral digoxin dose corresponds to approximately how many micrograms per kilogram?

• A. 5 mcg/kg
• B. 10 mcg/kg
• C. 20 mcg/kg
• D. 50 mcg/kg

Answer: (C)

Dosing digoxin in kids hinges on its narrow therapeutic index and how the drug is cleared, which makes it essential to know safe upper limits. The maximum oral dose is typically considered about 20 micrograms per kilogram. This ceiling helps prevent toxicity, which can show up as nausea, vomiting, bradycardia, or dangerous heart rhythm disturbances.

In practice, many pediatric regimens use lower daily maintenance doses that are spread out and tailored to weight, renal function, and overall clinical condition, but staying near or below the 20 mcg/kg/day ceiling helps minimize the risk of toxicity. The other options are either well below common maximums or far above what’s regarded as a safe upper limit for oral dosing.