Digoxin Immune Fab
Digoxin toxicity with hemodynamic instability, arrhythmias, or hyperkalemia
Indications
- Digoxin toxicity with hemodynamic instability, arrhythmias, or hyperkalemia
Adult dosing
- known dose: dose: 0; unit: vials = (dose ingested mg × 0.8) / 0.5; route: IV; fixed: true; empiric: dose: 10; maxDose: 20; unit: vials; route: IV; fixed: true; chronic toxicity: dose: 3; maxDose: 6; unit: vials; route: IV; fixed: true
Pediatric dosing
- empiric: dose: 5; maxDose: 10; unit: vials; route: IV; fixed: true
Clinical pearls
- Indications: life-threatening arrhythmia, K+ >5.0, hemodynamic instability, acute ingestion >10mg (adult) or >4mg (child)
- Empiric dose: 10-20 vials for acute overdose, 3-6 vials for chronic toxicity
- Digoxin level will be falsely elevated after Fab treatment — do not re-dose based on level
- AVOID calcium in digoxin toxicity — use Fab instead
Source and review
- Goldfrank's Toxicologic Emergencies; AHA ACLS Guidelines. Last reviewed: 2024-11-01