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Is there a superior digitalis preparation in terms of therapeutic safety?
No, not if you consider the speed of uptake of the digitalis preparation. For example, ouabain or acetylstrophanthidin may very rapidly produce evidence of digitalis intoxication, but this is because onset of their therapeutic action is so rapid. Of course, one must remember that they are also excreted very rapidly. This is one of the reasons we use a test dose.
I would concur that no single digitalis preparation has proved to have a significantly greater therapeutic safety factor.
We are apparently unanimous in noting that in our experience and with due consideration of the classification of preparations in terms of rapidity of action and excretion, there is no evidence that a particular standard digitalis preparation is superior to all others in terms of a greater margin of safety.When a rapidly-acting digitalis preparation is
Progress of Patient's Heart Disease May Indicate Smaller Digitalis Dosage. JAMA. 1964;189(9):31–34. doi:10.1001/jama.1964.03070090063040