Digoxin immune fab
 Bottle of digoxin immune fab | |
| Clinical data | |
|---|---|
| Trade names | Digibind, others |
| AHFS/Drugs.com | Consumer Drug Information |
| Pregnancy category |
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| Routes of administration | IV infusion, injection |
| ATC code | |
| Pharmacokinetic data | |
| Biological half-life | 15 hours for DigiFab, 23 hours for Digibind |
| Excretion | Renal |
| Identifiers | |
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| DrugBank | |
| ChemSpider |
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| ChEMBL | |
| Chemical and physical data | |
| Formula | C6394H9908N1698O2011S5 |
| Molar mass | 142,903.77 g·mol−1 |
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Digoxin immune fab or Digoxin-specific antibody is an antidote for overdose of digoxin.[1] It is made from immunoglobulin fragments from sheep that have already been immunized with a digoxin derivative, digoxindicarboxymethoxylamine (DDMA). Its brand names include Digibind (GlaxoSmithKline) and DigiFab (BTG plc).
Medical uses
It is used for digoxin toxicity when one of the following is present:[2][3]
- 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.
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.
References
- ↑ 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. PMID 11150387. doi:10.1053/XV.2000.5590.
- ↑ "Digoxin Toxicity". LITFL • Life in the Fast Lane Medical Blog. Retrieved 24 July 2017.
- ↑ "Digibind, DigiFab (digoxin immune FAB (Antidote)) dosing, indications, interactions, adverse effects, and more". reference.medscape.com. Retrieved 24 July 2017.