metabolites include digitoxigenin, digoxin (>2%), and conjugate esters. In healthy people, 60% are eliminated via the kidneys and 40% via the faeces. In people with impaired kidney function, elimination via the faeces is increased. The biological half-life is 7 to 8 days except when kidney and liver functions are impaired, in which case it is usually longer. History The first description of the use of foxglove dates back to 1775. For quite some time, the active compound was not isolated. Oswald Schmiedeberg was able to obtain a pure sample in 1875. The modern therapeutic use of this molecule was made possible by the works of the pharmacist and the French chemist Claude-Adolphe Nativelle (1812–1889). The first structural analysis was done by Adolf Otto Reinhold Windaus in 1925, but the full structure with an exact determination of the sugar groups was not accomplished until 1962. Use as a weapon Marie Alexandrine Becker, a Belgian serial killer, was sentenced to death for poisoning eleven people with digitoxin. In fiction Digitoxin is used as a poison or murder weapon in: Agatha Christie's Appointment with Death Elizabeth Peters' Die For Love CSI, season 9, episode 19: "The Descent of Man" Rosewood season 2, episode 20: Calliphoridae and Country Roads "Casino Royale" (2006) "Uneasy Lies the Crown" on Columbo, season 9, episode 5 (1990) "Affair of the Heart" on McMillan and Wife, season 6, episode 5 (1977) Murder 101: "College can be a Murder" Several episodes of Murder She Wrote. Private Practice, season 4, episode 18: “The Hardest Part” In The Decemberists's song, "The Rake's Song" on The Hazards of Love album, the narrator murders his daughter by feeding her foxglove. Research Digitoxin and related cardenolides display anticancer activity against a range of human cancer cell lines in vitro but the clinical use of digitoxin to treat cancer has been restricted by its narrow therapeutic index. Digitoxin glycorandomization led to the discovery of novel digitoxigenin neoglycosides which displayed improved anticancer potency and reduced inotropic activity (the perceived mechanism of general toxicity). References Further reading External links Comparing the Toxicity of Digoxin and Digitoxin in a Geriatric Population: Should an Old Drug Be Rediscovered? on Medscape , a convenience link from the original. Cardenolides Estrogens Merck brands