Digoxin immune fab Side Effects
For the Consumer
Applies to digoxin immune fab: intravenous solution reconstituted
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
- Very bad dizziness or passing out.
- A fast heartbeat.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
For Healthcare Professionals
Applies to digoxin immune fab: injectable powder for injection, injectable solution
Hypersensitivity side effects have rarely included general febrile state, urticarial rash, facial swelling and redness, and frank anaphylaxis. In cases of severe hypersensitivity side effects, prompt discontinuation of the drug is recommended.[Ref]
Cardiovascular side effects may arise as the clinical effectiveness of digoxin wanes (upon binding to Fab). Preexisting or new heart failure may require substitution of other inotropic agents and/or the addition of diuretics and/or vasodilators. Patients with atrial fibrillation become at increased risk for a rapid ventricular response rate in the absence of therapeutic serum digoxin concentrations.
Animal data have shown that decreased left ventricular contractility only slowly develops after digoxin immune Fab administration. Cardiac glycosides should NOT be used to treat decreased cardiac output in patients with documented cardiac glycoside intoxication!
While some inotropic agents may become necessary to maintain cardiac output, be cognizant that the catecholamine release associated with some drugs, such as dopamine or dobutamine, can exacerbate the significant risk of life-threatening arrhythmias associated with cardiac glycoside toxicity.[Ref]
Cardiovascular side effects have included new or exacerbation of existing physical and electrical cardiac conditions.[Ref]
A common metabolic problem associated with digoxin immune Fab therapy is the development of hypokalemia. Reversal of digoxin-mediated inhibition of the ATP-ase Na+/K+ pump enables potassium to shift back to the intracellular space, promoting the risk of hypokalemia. Patients with digoxin toxicity are usually total body potassium depleted, require close observation (serum potassium concentrations and ECG monitoring), and require cautious potassium replacement. (Rapid potassium replenishment can induce arrhythmias and easily cause hyperkalemia in this situation.)[Ref]
Metabolic side effects have included hypokalemia.[Ref]
Other side effects have included interference with the standard radioimmunoassay for digoxin and digitoxin.[Ref]
Accurate laboratory serum measurements of free, unbound, active digoxin may not be available for days in patients with normal renal function or for at least one week in patients with reduced renal function.[Ref]
1. "Product Information. Digibind (digoxin immune FAB)." Glaxo Wellcome, Research Triangle Park, NC.
Some side effects of digoxin immune fab may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
More about digoxin immune fab
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- Drug class: antidotes
Other brands: DigiFab
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