Excretion Renal | ATC code V03AB24 (WHO) | |
 | ||
AHFS/Drugs.com Consumer Drug Information Pregnancycategory US: C (Risk not ruled out) Biological half-life 15 hours for DigiFab, 23 hours for Digibind | ||
Digoxin immune fab or Digoxin-specific antibody is an antidote for overdose of digoxin. It is made from immunoglobulin fragments from sheep that have already been immunized with a digoxin derivative, digoxindicarboxymethoxylamine. Its brand names include Digibind (GlaxoSmithKline) and DigiFab (BTG plc).
Contents
Pharmacology
It works by binding to the digoxin, rendering it unable to bind to its action sites on target cells. The complexes accumulate in the blood and are expelled by the kidney.
Indications
- Hemodynamically unstable arrhythmia
- End organ damage
- digoxin level > 4 ng/ml if chronic ingestion
- digoxin level > 10 ng/ml if acute ingestion
- potassium > 5 mEq/L and symptomatic
Contraindications
Avoid use in hypokalemia as this drug, while reversing the effects of digitalis, will further reduce serum potassium levels and could precipitate dangerous and even fatal cardiac arrhythmias.
The patient must be closely monitored for anaphylactic shock, and anyone allergic to sheep protein, papain, bromelain, or papaya extracts (papain is used to cleave the antibody into Fab and Fc fragments) should not use ovine digoxin immune fab. Because it is relatively new, no drug interaction studies have been performed yet.