Digifab (digoxin immune fab)

Digoxin immune Fab (ovine) is commercially available in the US as DigiFab(R) (40-mg single-use vials). Although a different preparation of digoxin immune Fab (ovine) also was previously available (Digibind(R)) and product-specific dosage recommendations were required, this other preparation of digoxin immune Fab (ovine) is no longer commercially available in the US.

Digoxin immune Fab (ovine) usually is given as a single dose. If toxicity is not adequately reversed within several hours after administration of the dose or if toxicity recurs, an additional dose of digoxin immune Fab (ovine) may be necessary and clinical judgment should be used to guide dose selection.

The contents of one vial of DigiFab(R) neutralizes approximately 0.5 mg of digoxin. For treatment of life-threatening or potentially life-threatening digoxin toxicity, the dose of digoxin immune Fab (ovine) varies according to the amount of digoxin to be neutralized.

When the amount of digoxin ingested is unknown and cannot be estimated and when serum digoxin concentrations are unavailable, general dosing guidelines can be used and may be adequate to treat most life-threatening digoxin overdosages. (See General Dosing for Digoxin Toxicity under Dosage and Administration: Dosage.)

If the amount of digoxin ingested is known, the dose of digoxin immune Fab (ovine) required to neutralize the cardiac glycoside can be calculated using an estimate of the total body load (TBL) of digoxin, which takes into consideration the amount (mg of digoxin) and bioavailability of the digoxin preparation ingested. Alternatively, the dose of digoxin immune Fab (ovine) can be calculated based on steady-state serum digoxin concentrations. (See Calculated Dose for Digoxin Toxicity under Dosage and Administration: Dosage.)

If there is no response to an adequate dose of digoxin immune fab (ovine), the possibility that the clinical problem is not caused by digitalis intoxication should be considered and the diagnosis should be re-evaluated.

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

• Severe renal impairment

There is no enhanced messaging for this drug.

Rare or Very Rare

• Anaphylaxis
• Hypokalemia
• Worsening of chronic heart failure

Rare or Very Rare

• Orthostatic hypotension
• Phlebitis after infusion

No enhanced messaging available.

No enhanced messaging available.

Animal reproduction studies have not been performed with digoxin immune Fab (ovine) and it is not known whether the immune Fab can cause fetal harm when administered to pregnant women or can affect reproductive capacity. Digoxin immune Fab (ovine) should be used during pregnancy only when clearly needed.

Since it is not known whether digoxin immune Fab (ovine) is distributed into milk, the immune Fab should be used with caution in nursing women and should only be used in such women when clearly needed.

No enhanced messaging available.