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Digoxin Immune Fab Brand Names- Digibind | Digifab
What is Digoxin Immune Fab
Digoxin immune Fab is a protein that consists of antibody fragments, which are used as an antidote for digitalis toxicity.
The antibody fragments are obtained by immunizing sheep with a digoxin derivative (DigiFab), isolating immunoglobulins from the sheep serum, digesting the immunoglobulins with papain, and obtaining the specific antibody fragments through affinity chromatography.
The antibody fragments (Fab) represent the antigen-binding section of an immunoglobulin (IgG).
The Fab fragments are smaller, exhibit less antigenicity, have greater distribution, and are eliminated faster than the larger IgG parent. Digoxin immune Fab will bind both digoxin and digitoxin molecules, although the binding affinity for the antidote is greater for digoxin than for digitoxin.
Digibind was approved by the FDA in 1986 but is no longer marketed in the U.S.; DigiFab was approved by the FDA in August of 2001.
Indications
- cardiac glycoside-induced arrhythmias
- digitoxin overdose
- digitoxin toxicity
- digoxin overdose
- digoxin toxicity
For the treatment of life-threatening or potentially life-threatening digoxin toxicity, digitoxin toxicity, digoxin overdose, or digitoxin overdose including known suicidal or accidental consumption of fatal doses of digoxin (i.e., 10 mg or more digoxin in adults, 4 mg or more or 0.1 mg/kg or more in children, or ingestion resulting in serum concentrations greater than 10 ng/mL; chronic ingestions resulting in steady-state digoxin concentrations greater than 6 ng/mL in adults or greater than 4 ng/mL in children; and manifestations of digoxin toxicity due to overdose (e.g., life-threatening cardiac glycoside-induced arrhythmias, progressive bradycardia, second or third degree heart block unresponsive to atropine, serum potassium greater than 5.5 mEq/L in adults or greater than 6 mEq/L in children)
for acute ingestion of an unknown amount of digoxin or digitoxin (e.g., either the serum concentration or the amount ingested is not known)
Side Effects
- anaphylactoid reactions
- angioedema
- antibody formation
- atrial fibrillation
- heart failure
- hypokalemia
- hypotension
- infusion-related reactions
- injection site reaction
- orthostatic hypotension
- phlebitis
- pruritus
- rash
- urticaria
- wheezing
Monitoring Parameters
- ECG
- serum creatinine/BUN
- serum free digoxin concentrations
- serum potassium
Contraindications
- acid/base imbalance
- breast-feeding
- electrolyte imbalance
- geriatric
- hypokalemia
- ovine protein hypersensitivity
- papain hypersensitivity
- pregnancy
- renal failure
- renal impairment
Interactions
- Cardiac glycosides
- Digitoxin
- Digoxin
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