Generic Name: digoxin immune FAB (di JOX in im MYOON FAB)
Brand Names: Digibind, DigiFab
What is digoxin immune FAB?
Digoxin immune FAB is used as an antidote to treat a life-threatening overdose of digoxin or digitoxin.
Digoxin immune FAB is not for treating a mild digitalis overdose.
Digoxin immune FAB may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about digoxin immune FAB?
If possible, before you receive digoxin immune FAB, tell your doctor if you have heart disease or kidney disease, or if you are allergic to antibiotics or papaya extracts such as papain or chymopapain.
In an emergency situation, it may not be possible before you are treated to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for you afterward knows that you received this medication.
After treatment with digoxin immune FAB, you will be watched to make sure the medication has been effective and you no longer have any effects of the digitalis overdose.
What should I discuss with my health care provider before receiving digoxin immune FAB?
If possible, before you receive digoxin immune FAB, tell your doctor if you have:
heart disease;
kidney disease;
if you are allergic to antibiotics; or
if you are allergic to papaya extracts such as papain or chymopapain (Chymodiactin).
FDA pregnancy category C. Digoxin immune FAB may be harmful to an unborn baby. Tell your doctor if you are pregnant before receiving this medication. It is not known whether digoxin immune FAB passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
In a poisoning situation, it may not be possible to tell your caregivers that you are pregnant or breast-feeding before you are treated with digoxin immune FAB. However, make sure any doctor caring for your pregnancy or your baby knows that you have received the medication.
How is digoxin immune FAB given?
Digoxin immune FAB is given as an injection through a needle placed into a vein. You will receive this injection in a hospital or emergency setting. The medicine must be given slowly through an IV infusion, and each dose can take up to 30 minutes to complete.
To be sure this medication is helping your condition and not causing harmful side effects, your blood will need to be tested on a regular basis. This will help your doctor determine how long to treat you with digoxin immune FAB.
This medication can cause you to have unusual results with certain digitalis tests. Tell any doctor who treats you that you have been treated with digoxin immune FAB.
What happens if I miss a dose?
Since digoxin immune FAB is given in an emergency situation by a healthcare professional, it is not likely that you will miss a dose.
What happens if I overdose?
An overdose of this medication is unlikely since it is given by a healthcare provider.
What should I avoid after receiving digoxin immune FAB?
Follow your doctor's instructions about any restrictions on food, beverages, or activity after you are treated with digoxin immune FAB.
Digoxin immune FAB side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have any of these serious side effects:
fever;
high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling);
low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);
feeling short of breath, even with mild exertion; or
swelling, rapid weight gain.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Digoxin immune FAB Dosing Information
Usual Adult Dose for Digitalis Glycoside Toxicity:
Unknown amount of ingestion: 800 mg IV infusion if acute ingestion, 240 mg IV infusion if chronic ingestion.
Dosing for Ingestion of a Single Large Dose:
Dose (in # of vials) = (Total digitalis body load in mg) / (0.5 mg of digitalis bound per vial).
Total digitalis body load in mg = (number of tablets/capsules ingested) x (mg strength of the tablet/capsule) x (bioavailability of tablet/capsule). Digoxin tablets and elixir are 80% bioavailable, digoxin capsules and injection are 100% bioavailable.
Dosing based on Serum Level:
Digoxin: Dose (in # of vials) = (Serum digoxin level in ng/mL) x (weight in kg) / (100).
Digitoxin: Dose (in # of vials) = (Serum digitoxin level in ng/mL) x (weight in kg) / (1000).
Digoxin immune Fab should be administered intravenously once over at least 30 minutes or, in the case of imminent cardiac arrest, as a bolus injection.
The above dosing scenarios are based on the following: each vial contains 40 mg of immune Fab; each vial will bind approximately 0.5 mg of cardiac glycoside.
Usual Pediatric Dose for Digitalis Glycoside Toxicity:
Dosing for Ingestion of a Single Large Dose:
Dose (in # of vials) = (Total digitalis body load in mg) / (0.5 mg of digitalis bound per vial).
Total digitalis body load in mg = (number of tablets/capsules ingested) x (mg strength of the tablet/capsule) x (bioavailability of tablet/capsule). Digoxin tablets and elixir are 80% bioavailable, digoxin capsules and injection are 100% bioavailable.
Children less than or equal to 20 kg: Dilution of reconstituted vial to 1 mg/mL may be desirable for doses of 3 mg or less.
Dose ( in # of mg) = Dose (in # vials) x 38 mg/vial.
Dose (in # of vials) = (Serum digoxin level in ng/mL) x (weight in kg) / (100).
Digoxin immune Fab should be administered intravenously once over at least 30 minutes or, in the case of imminent cardiac arrest, as a bolus injection. The vial may be reconstituted and administered undiluted using a tuberculin syringe in infants and small children requiring small doses.
The above dosing scenarios are based on the following: each vial contains 40 mg of immune Fab; each vial will bind approximately 0.5 mg of cardiac glycoside.
What other drugs will affect digoxin immune FAB?
This list is not complete and there may be other drugs that can interact with digoxin immune FAB. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
More digoxin immune FAB resources
- Digoxin immune FAB Side Effects (in more detail)
- Digoxin immune FAB Use in Pregnancy & Breastfeeding
- Digoxin immune FAB Drug Interactions
- Digoxin immune FAB Support Group
- 0 Reviews for Digoxin immune FAB - Add your own review/rating
- Digibind Prescribing Information (FDA)
- Digifab Prescribing Information (FDA)
- Digoxin Immune Fab MedFacts Consumer Leaflet (Wolters Kluwer)
Compare digoxin immune FAB with other medications
- Digitalis Glycoside Toxicity
Where can I get more information?
- Your doctor or pharmacist can provide more information about digoxin immune FAB.
See also: digoxin immune FAB side effects (in more detail)
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