DigiFab Disease Interactions

Severe digitalis intoxication can result in life-threatening elevations of serum potassium as potassium is shifted from inside the cell to the serum. Elevated serum potassium leads to increased renal elimination of potassium and can result in a total body deficit of potassium. Hypokalemia may develop rapidly following digoxin immune Fab as potassium reenters the cells. Serum potassium concentrations should be monitored prior to, during and following digoxin immune Fab therapy and cautiously replaced as necessary.

Digoxin immune Fab is eliminated by the kidney complexed to digoxin or digitoxin. The elimination half-life of digoxin immune Fab has not been fully defined, however it is expected to be prolonged in patients with severe renal impairment. It is uncertain if failure to eliminate the complex can lead to reintoxication following the release of complexed digoxin/digitoxin. Therapy with digoxin immune Fab should be administered cautiously in patients with severe renal dysfunction. Clinical monitoring of renal function and symptoms of toxicity should be monitored for an extended time. Digoxin immune Fab interferes with digitalis immunoassay measurements.