Digoxin immune fab
|Systematic (IUPAC) name|
Anti-digoxin antibody fragment
|IV infusion, injection|
|Biological half-life||15 hours for DigiFab, 23 hours for Digibind|
|Molar mass||144602.257 g/mol|
|(what is this?)|
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).
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.
- Hemodynamically unstable arrhythmia
- End organ damage
- digoxin level > 4ng/ml if chronic ingestion
- digoxin level > 10 ng/ml if acute ingestion
- potassium > 5 mEq/L and symptomatic 
Although no contraindications have been noted, 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.
- DiDomenico RJ, Walton SM, Sanoski CA, Bauman JL (2000). "Analysis of the use of digoxin immune fab for the treatment of non-life-threatening digoxin toxicity". J. Cardiovasc. Pharmacol. Ther. 5 (2): 77–85. doi:10.1053/XV.2000.5590. PMID 11150387.
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