Table 3.

Common indications and dosing recommendations for Digoxin-specific Fab. The dosing schedule varies according to the specific clinical scenario and whether the ingested amount or blood serum levels are known. Dosing is based on 38 or 40 mg vials. Adapted from Goldfrank's Toxicologic Emergencies, Ninth Edition [58]

Table 3. Indications and dosing for digoxin-specific Fab.
Indications: Symptomatic Dysrhythmia (e.g. bradydysrhytmias, ventricular dysrhythmias) Acute poisoning with serum potassium of over 5 mEq/L, Ingestion of over 4 mg in a child (0.1 mg/kg) or 10 mg in an adult, 4. A serum digoxin level of over 10 ng/mL in steady state measurement, or of over 15 ng/mL at any time.
Dosing: Unknown acute ingestion, 10 vials IV and repeated if necessary Life threatening toxicity, 20 vials Known amount, number of vials = digoxin ingested in mg multiplied by 0.8/ 0.5 mg bound per vial. For chronic ingestions: number of vials = (serum digoxin concentration in ng/mL) x (patient weight in kg)/100 rounded up to nearest integer.