**Core Concept**
Digoxin elimination involves both renal and non-renal pathways. The primary route of elimination for digoxin is through the kidneys, but the drug also undergoes enterohepatic recirculation and is metabolized by the gut and liver.

**Why the Correct Answer is Right**
The most important channel of elimination for digoxin is the renal route. Approximately 70% of digoxin is excreted unchanged in the urine, with the remaining 30% undergoing enterohepatic recirculation and metabolism. The kidneys excrete digoxin through a combination of glomerular filtration and tubular secretion. The renal excretion of digoxin is influenced by factors such as age, kidney function, and the presence of other medications that affect renal function.

**Why Each Wrong Option is Incorrect**
* **Option A:** While enterohepatic recirculation is an important pathway for digoxin elimination, it is not the most significant channel.
* **Option B:** Hepatic metabolism is a minor pathway for digoxin elimination.
* **Option D:** Biliary excretion is not a significant route for digoxin elimination.

**Clinical Pearl / High-Yield Fact**
In patients with renal impairment, the half-life of digoxin is prolonged, and the risk of toxicity increases. Therefore, it is essential to monitor serum digoxin levels and adjust the dose accordingly in patients with kidney disease.

**Correct Answer: C. Renal route**