Digoxin Immune FAB Antidote

Digoxin Immune FAB (Antidote) is a prescription antidote used for treating digoxin poisoning.

• Digoxin Immune FAB is available under the following different brand names: Digibind, DigiFab

Adult and pediatric dosage

Powder for injection

• 40mg/vial

Acute Ingestion of Unknown Quantity

Adult and pediatric dosage

• Administer 20 vials
• A larger dose has a faster onset, but may cause a febrile reaction; may give 10 vials initially, then at the physician's discretion, administer 10 more vials
• Each vial of DigiFab (40 mg of Fab) binds 0.5 mg of digoxin
• Equimolar dose to ingested digoxin (76/80 mg FAB = 1 mg digoxin)

Acute Ingestion of Known Amount

Adult and pediatric dosage

• Total digoxin load (mg) divided by 0.5 mg digoxin bound per vial = number of vials to use

Toxicity During Chronic Therapy

Adult and pediatric dosage

• Acute distress or for whom a serum digoxin concentration is not available: Administer 6 vials
• Infants and small children (weight below 20 kg): Administer 1 vial

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Digoxin Immune FAB include:

• heart problems, and
• low potassium

Serious side effects of the Digoxin Immune FAB include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• itching,
• skin redness,
• wheezing,
• cough,
• lightheadedness,
• fever,
• swollen glands,
• itching,
• joint pain,
• not feeling well,
• swelling,
• rapid weight gain,
• shortness of breath,
• leg cramps,
• constipation,
• irregular heartbeats,
• fluttering in the chest,
• increased thirst,
• increased urination,
• numbness or tingling,
• muscle weakness, and
• limp feeling

Rare side effects of Digoxin Immune FAB include:

none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Digoxin Immune FAB has no noted severe interactions with any other drugs.
• Digoxin Immune FAB has no noted serious interactions with any other drugs.
• Digoxin Immune FAB has no noted moderate interactions with any other drugs.
• Digoxin Immune FAB has no noted minor interactions with any other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to sheep proteins

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Digoxin Immune FAB?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Digoxin Immune FAB?”

Cautions

• Serum digoxin levels rise after digibind treatment - do not use serum levels to guide continuing treatment
• Hypokalaemia may occur from the shifting of extracellular potassium to intracellular space; monitor closely
• Patients with heart failure may experience symptom exacerbation due to a reduction in digoxin serum concentration
• Caution in patients with renal failure

Pregnancy & Lactation

• Use with caution if the benefits outweigh the risks.
• Lactation
  • Excretion in milk unknown; use with caution