Key result
DigiFab effectively treats acute and chronic digoxin toxicity using dosing guided by weight and serum levels.
Digoxin immune fab is indicated for digoxin toxicity based on specific clinical and laboratory criteria, and post-administration digoxin levels should not be measured due to false elevations.
Streamlines DigiFab dosing in life-threatening digoxin toxicity; leaves open prospective validation in cardioactive steroid poisoning.
The DigiFab® Dosing calculator guides DigiFab® (Digoxin Immune Fab- Ovine) dosing in patients with confirmed digoxin poisoning or overdose. This calculator can be used for acute, acute on chronic digoxin toxicity or for poisoning with cardioactive steroids. It is indicated for any digoxin -related life-threatening dysrhythmia (independent of the digoxin level). Digoxin immune fab is indicated for acute digoxin toxicity with serum potassium concentration > 5.5 mEq/L, serum digoxin level > 15 ng/mL (19.2 nmol/L) at any time or > 10 ng/mL (12.8nmol/L) 6-hours post ingestion, acute ingestion of > 10 mg of digoxin in adults or acute ingestion > 4mg digoxin in a child, rhythm and conduction disturbances or empirically in critically unstable patients. Clinicians should consider the type of dysrhythmia present at the time of presentation, along with the timing of the ingestion with consultation with a poison control center or a toxicologist prior to the administration of DigiFab®. Clinicians should note that measuring serum digoxin levels after administration of DigiFab® are not recommended and may be falsely elevated.
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Ahuja et al. (2026) conducted a review in Digoxin poisoning. DigiFab (Digoxin Immune Fab) was evaluated. DigiFab is an effective antidote for acute and chronic digoxin toxicity, with dosing calculated based on serum digoxin levels and patient weight or the total amount of digoxin ingested.
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