Digoxin immune fab

Digoxin immune fab

Systematic (IUPAC) name
Anti-digoxin antibody fragment
Clinical data
AHFS/Drugs.com	Consumer Drug Information
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	IV infusion, injection
Pharmacokinetic data
Biological half-life	15 hours for DigiFab, 23 hours for Digibind
Excretion	Renal
Identifiers
ATC code	V03AB24 (WHO)
DrugBank	DB00076 Y
ChEMBL	CHEMBL1201588 N
Chemical data
Formula	C6394H9908N1698O2011S58
Molecular mass	144602.257 g/mol
NY (what is this?)  (verify)

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).

Digoxin immune fab used to treat digoxin toxicity

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

1. Hemodynamically unstable arrhythmia
2. End organ damage
3. digoxin level > 4 ng/ml if chronic ingestion
4. digoxin level > 10 ng/ml if acute ingestion
5. 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.

External links

• Drug information online
• Digibind description