Digoxin immune fab

Digoxin immune fab
Clinical data
AHFS/Drugs.com Consumer Drug Information
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration		 IV infusion, injection
ATC code V03AB24 (WHO)
Pharmacokinetic data
Biological half-life 15 hours for DigiFab, 23 hours for Digibind
Excretion Renal
Identifiers
DrugBank DB00076 YesY
ChemSpider none
ChEMBL CHEMBL1201588 N
Chemical and physical data
Formula C6394H9908N1698O2011S58
Molar mass 144602.257 g/mol
 NYesY (what is this?)  (verify)

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. 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 [2]

[3]

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.

References

  1. ↑ 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.
  2. ↑ http://reference.medscape.com/drug/digibind-digifab-digoxin-immune-fab-antidote-343725
  3. ↑ http://lifeinthefastlane.com/ccc/digoxin-toxicity/


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