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Digoxin immune Fab (DigiFab) dosing for digoxin poisoning

Digoxin immune Fab (DigiFab) dosing for digoxin poisoning
Dosing method
Serum digoxin concentration
ng/mL
Body weight
Amount of digoxin ingested
mg
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When to use

  • Calculating digoxin-specific antibody (Fab) dose in acute or chronic digoxin toxicity when the level or ingested amount is known.
  • For unknown ingestion with instability, empiric dosing (about 10-20 vials acute, 6 vials chronic) is used instead.

Formula

From level: vials = (serum digoxin ng/mL x weight kg) / 100. From ingestion: vials = (mg ingested x 0.8) / 0.5. Round up to whole vials (each binds 0.5 mg digoxin).

References

  1. Antman EM, et al. Circulation. 1990;81(6):1744-52.