Digoxin Immune Fab (Bovine; Digoxin-Specific Antibody Fragments)(di jox’ in)
DigiFab
PREGNANCY CATEGORY C
Drug Classes
Antidote
Therapeutic Actions
Antigen-binding fragments (fab) derived from specific antidigoxin antibodies; binds molecules of digoxin, making them unavailable at the site of action; fab-fragment complex accumulates in the blood and is excreted by the kidneys.
Indications
Treatment of potentially life-threatening digoxin toxicity (serum digoxin level exceeding 10 nanograms/mL, serum K+ exceeding 5 mEq/L in setting of digoxin toxicity)
Contraindications and Cautions
Contraindicated with allergy to sheep products.
Use cautiously with pregnancy or lactation.
Available Forms
Powder for injection—40 mg/vial
Dosages
Adults and pediatric patients
Dosage is determined by serum digoxin level or estimate of the amount of digoxin ingested. If no estimate is available and serum digoxin levels cannot be obtained, use 800 mg (20 vials), which should treat most life-threatening ingestions in adults and children.
Estimated fab fragment dose based on amount of digoxin ingested:
Estimated Number of 0.25-mg Tablets or 0.2-mg Capsules Ingested
Dose (Number of Vials of DigiFab)
25
10
50
20
75
30
100
40
150
60
200
80
Estimated fab fragments dose based on serum digoxin concentration:
Wt (kg)
Serum Digoxin Concentration (ng/mL)
1
2
4
8
12
16
20
Pediatric patients (dose in mg)*
1
0.4
1
1.5
3
5
6.5
8
3
1
2.5
5
10
14
19
24
5
2
4
8
16
24
32
40
10
4
8
16
32
48
64
80
20
8
16
32
64
96
128
160
Adults (dose in vials)
40
0.5
1
2
3
5
7
8
60
0.5
1
3
5
7
10
12
70
1
2
3
6
9
11
14
80
1
2
3
7
10
13
16
100
1
2
4
8
12
16
20
*Dilution of reconstituted vial to 1 mg/mL is desirable. 
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