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Digibind

Category: Blood Pressure

Description

Lanoxin is used for treating heart failure and slowing the heart rate in patients with chronic atrial fibrillation, a type of abnormal heart rhythm.

Active Ingredient: Digoxin

Lanoxin (Digibind) as known as: Agoxin, Apo-digoxin, Cardiacin, Cardiogoxin, Digacin, Digazolan, Digibind, Digitek, Digobal, Digocard-g, Digohan, Digoregen, Digosin, Digossina, Digoxanova, Digoxen, Digoxine, Digoxinum, Eudigox, Fargoxin, Halfdigoxin, Lanadicor, Lanibos, Lanicor, Lenoxin, Pms-digoxin, Purgoxin, Sigmaxin, Vidaxil

Order Digibind 0, 25 mg pills without prescription

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Buy Digibind (Lanoxin) Online No Prescription

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Digibind Indications

Digibind is used for treating heart failure and slowing the heart rate in patients with chronic atrial fibrillation, a type of abnormal heart rhythm. Digibind is a digitalis glycoside. It works by increasing the force of contraction of the heart and slowing heart rate.

Digibind Instructions

Use Digibind as directed by your doctor.

  • Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
  • Take Digibind with a full glass of water.
  • Try to take the medication at the same time every day.
  • To be sure Digibind is not causing harmful effects, your blood may need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.
  • Keep taking Digibind as directed, even if you feel well. Get your prescription refilled before you run out of medicine completely.
  • Do not stop taking Digibind without first talking to your doctor. Stopping suddenly may make your condition worse.
  • If you miss a dose of Digibind, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Digibind.

Digibind Storage

Store Digibind at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Digibind out of the reach of children and away from pets.

Digibind More Info

Active Ingredient: Digoxin.

Do NOT use Digibind if:

  • you are allergic to any ingredient in Digibind or other digitalis medicines
  • you have beriberi heart disease
  • you have certain types of heart rhythm problems, such as ventricular fibrillation.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Digibind. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have severe heart failure, inflammation of the heart, coronary artery disease, heart attack, heart block, extra heart beats (PVCs), certain abnormal heart rhythms, or fainting due to a heart problem
  • if you have severe kidney, liver, or lung problems, or a thyroid problem
  • if you have low blood levels of calcium, magnesium, or potassium, or high blood levels of potassium or calcium.

Some medicines may interact with Digibind. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Amiodarone, amphotericin B, anticholinergics (eg, propantheline), beta-blockers (eg, propranolol), bupivacaine, calcium, certain stimulants (eg, albuterol, amphetamine, pseudoephedrine), cyclosporine, diltiazem, diphenoxylate, diuretics (eg, hydrochlorothiazide, furosemide), indomethacin, itraconazole, macrolides (eg, erythromycin), propafenone, quinidine, quinine, spironolactone, succinylcholine, tetracyclines (eg, doxycycline), thioamines (eg, methimazole), or verapamil because they may increase the risk of Digibind's side effects, especially on the heart
  • Acarbose, certain anticancer medicines, cholestyramine, colestipol, kaolin-pectin, metoclopramide, penicillamine, rifampin, sulfasalazine, or thyroid hormones (eg, levothyroxine) because they may decrease Digibind's effectiveness
  • Oral aminoglycosides (eg, neomycin) because the actions and side effects of Digibind may be increased or decreased
  • Spironolactone because it may interfere with certain lab tests for digoxin blood levels and give false readings.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Digibind may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important Digibind Safety Information
  • Digibind may cause dizziness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Digibind with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Tell your doctor or dentist that you take Digibind before you receive any medical or dental care, emergency care, or surgery.
  • Lab tests, including electrocardiogram (ECG), electrolytes, and blood digoxin levels, may be performed while you use Digibind. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Digibind with caution in the elderly; they may be more sensitive to its effects.
  • Use Digibind with extreme caution in infants who are premature or immature; they may be more sensitive to its effects.
  • Poisoning may occur in children who accidently swallow Digibind or receive too much medicine. In case of an overdose, call a doctor or poison control center right away.
  • Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Digibind while you are pregnant. Digibind is found in breast milk. If you are or will be breast-feeding while you use Digibind, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision, yellow vision, or other vision changes; confusion; fast, slow, or irregular heartbeat; hallucinations; mood or mental changes (eg, depression); severe or persistent nausea, vomiting, or stomach pain; unusual bruising or bleeding; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

Clinical trial: Marinobufagenin as a Target for DIGIBIND in Hypertensive Patients With End-stage Renal Disease

Marinobufagenin as a Target for DIGIBIND in Hypertensive Patients With End-stage Renal Disease

Information source: National Institute on Aging (NIA)
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Hypertension; Hemodialysis

Intervention: Digoxin immune fab (Drug); Placebo (Drug)

Status: Active, not recruiting

Sponsored by: National Institute on Aging (NIA)

Official(s) and/or principal investigator(s):
Deepak Malhotra, MD, PhD, Principal Investigator, Affiliation: University of Toledo

The purpose of this study is to examine the effects of the digibind drug on hemodialysis patients with high blood pressure. Digibind is used to treat toxicity from digoxin and digoxin-like molecules which may contribute to high blood pressure.

Official title: Marinobufagenin as a Target for DIGIBIND in Hypertensive Patients With End-stage Renal Disease

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: Blood pressure

Secondary outcome: Marinobufagenin levels

Detailed description: High blood pressure is a very common problem in patients with kidney disease. Researchers have noted that there are certain molecules in the blood of these patients that may be contributing to the high blood pressure. In particular these molecules have been labeled as "digoxin-like substances." Digoxin is a drug made from a certain plant that may contribute to high blood pressure. In research animals with kidney failure, it has been noted that the use of Digibind helps to lower the blood pressure in these animals. Digibind is a drug made from sheep that is used to treat the toxicity from digoxin as well as toxicity from molecules similar to digoxin. In this study, volunteers that are on hemodialysis and have high blood pressure will be given a placebo or the digibind drug intravenously on two separate visits. The volunteers will then wear a 24-hour blood pressure monitor and return the following day. Volunteers will receive the Digibind at one visit during the study, and the placebo on the other visit.

Minimum age: 18 Years. Maximum age: 75 Years. Gender(s): Both.

Criteria: Inclusion Criteria:

- Aged 18-75 years of age

- On at least one anti-hypertensive medication for 6 consecutive readings

- Able to have blood pressure measured in an arm

- Women of child bearing potential must not be pregnant; must use contraception during

the study and for one month after the study

- Receiving adequate dialysis (KT/V > 1. 2)

- Compliant with the dialysis schedule and duration

- Pregnant or nursing women

- Arm blood pressure is not possible to obtain

- Currently on digitalis

- On any Digibind-type product in the past

- History of allergies to antibiotics

- History of asthma

- Medical or psychiatric disorders which are unstable or which might interfere with

study assessments or safe participation in the study

- History of use of, or evidence of need for, digitalis-like products

- Inability to understand or provide informed consent

Locations and Contacts

University of Toledo Medical Center, Toledo, Ohio 43614, United States Additional Information

Bagrov AY, Shapiro JI. Endogenous digitalis: pathophysiologic roles and therapeutic applications. Nat Clin Pract Nephrol. 2008 Jul;4(7):378-92. doi: 10.1038/ncpneph0848. Epub 2008 Jun 10. Review.

Mohmand B, Malhotra DK, Shapiro JI. Uremic cardiomyopathy: role of circulating digitalis like substances. Front Biosci. 2005 Sep 1;10:2036-44. Review.

Fedorova OV, Simbirtsev AS, Kolodkin NI, Kotov AY, Agalakova NI, Kashkin VA, Tapilskaya NI, Bzhelyansky A, Reznik VA, Frolova EV, Nikitina ER, Budny GV, Longo DL, Lakatta EG, Bagrov AY. Monoclonal antibody to an endogenous bufadienolide, marinobufagenin, reverses preeclampsia-induced Na/K-ATPase inhibition and lowers blood pressure in NaCl-sensitive hypertension. J Hypertens. 2008 Dec;26(12):2414-25. doi: 10.1097/HJH.0b013e328312c86a.

Starting date: April 2009
Last updated: May 23, 2012

Page last updated: August 23, 2015

Article Page

Reversal of sodium pump inhibitor induced vascular smooth muscle contraction with digibind Stoichiometry and its implications
  • Hans Henning Krep
  • Steven W. Graves
  • Deborah A. Price
  • Michael Lazarus
  • Allison Ensign
  • Piotr A. Soszynski
  • Norman K. Hollenberg
  • Departments of Medicine and Radiology, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA

Received 22 February 1995. Accepted 30 June 1995. Available online 1 March 1999.

Abstract

The possibility that a circulating sodium pump inhibitor contributes to the pathogenesis of volume-dependent hypertension via an action on vascular smooth muscle (VSM) is supported by multiple lines of investigation, but remains controversial. We had two goals in this study. The first was to compare the pattern of contractile response of rabbit aorta induced by two candidates, ouabain and a labile sodium pump inhibitor that we have identified in the peritoneal dialysate of volume-expanded hypertensive patients with chronic renal failure. Our second goal was to examine the ability of Digibind, a Fab fragment of antisera directed against digoxin, to reverse VSM contraction induced by both agents. Ouabain induced a concentration-dependent contraction, which was delayed in onset, was gradual, and reached a stable plateau after many hours. The labile sodium pump inhibitor induced a qualitatively similar series of responses. Digibind rapidly reversed the contractile responses to both sodium pump inhibitors, with a rate of relaxation that matched that induced by physical removal of the pump inhibitor from the bath. For ouabain, the Digibind:ouabain stoichiometry was highly predictable. When Digibind was present in a molar concentration equivalent to that of ouabain, or less, it had no effect. When the Digibind concentration was twice that of ouabain, complete relaxation occurred. Although the concentration:VSM response relationship for ouabain was steep, the concentration:effect interaction with Digibind was even more steep. The molar concentration of Digibind required to reverse the effects of the labile endogenous inhibitor from peritoneal dialysate was consistently lower than that for ouabain, which is compatible with either greater potency of the labile factor in VSM or greater affinity for Digibind. These findings are compatible with a role for one or more endogenous sodium pump inhibitors as the determinant of vascular smooth muscle tone in the volume-sensitive hypertension of renal disease.

Keywords
  • Ouabain
  • digitalis-like factor
  • rabbit aorta
  • Na
  • K-ATPase
  • Digibind
  • vascular smooth muscle

Address correspondence and reprint requests Norman K. Hollenberg, MD, PhD, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Copyright © 1996 Published by Elsevier Inc.

Citing articles ( )

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Digibind (Digoxin Immune Fab) Drug Information: Description, User Reviews, Drug Side Effects, Interactions - Prescribing Information at RxList

DRUG DESCRIPTION

DIGIBIND, Digoxin Immune Fab (Ovine), is a sterile lyophilized powder of antigen binding fragments (Fab) derived from specific antidigoxin antibodies raised in sheep. Production of antibodies specific for digoxin involves conjugation of digoxin as a hapten to human albumin. Sheep are immunized with this material to produce antibodies specific for the antigenic determinants of the digoxin molecule. The antibody is then papain-digested and digoxin-specific Fab fragments of the antibody are isolated and purified by affinity chromatography. These antibody fragments have a molecular weight of approximately 46,200.

Each vial, which will bind approximately 0.5 mg of digoxin (or digitoxin), contains 38 mg of digoxin-specific Fab fragments derived from sheep plus 75 mg of sorbitol as a stabilizer and 28 mg of sodium chloride. The vial contains no preservatives.

DIGIBIND (digoxin immune fab) is administered by intravenous injection after reconstitution with Sterile Water for Injection (4 mL per vial).

What are the possible side effects of digoxin immune FAB (Digibind, DigiFab)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have any of these serious side effects:

  • fever;
  • high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling);
  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);
  • feeling short of breath, even with mild exertion; or
  • swelling, rapid.

Last reviewed on RxList: 10/14/2008
This monograph has been modified to include the generic and brand name in many instances.

Efficacy Study of Digibind for Treatment of Severe Preeclampsia

Efficacy Study of Digibind for Treatment of Severe Preeclampsia Summary

The purpose of this study is to determine whether a commercially available anti-digoxin antibody, Digibind, can delay delivery in patients with severe pre-eclampsia. If so, this would allow more time for maternally administered steroids to prevent the development of respiratory complications in premature infants.

Description

Preeclampsia (PE) is a serious complication of third trimester pregnancy manifested by high blood pressure, proteinuria, edema, encephalopathy sometimes with seizures, and hepatic failure. There is no known specific treatment, although palliative measures such as antihypertensive drugs, magnesium, steroids and early delivery improve outcomes. Multiple abnormalities have been demonstrated in PE but the relation of these abnormalities to the cause, pathophysiology and treatment is unknown. One of these abnormalities is elevation in the circulating level of a "digoxin-like" factor (EDLF), an unknown substance that cross reacts with digoxin antibodies and inhibits Na,K ATPase. An extensive literature supports the hypothesis that increased levels of EDLF may be a causative factor in the pathogenesis of hypertension. Increased levels of this factor are found both in maternal and fetal blood, both in normal pregnancy, and in pregnancy complicated by PE. Levels of this factor are higher in PE than in normal pregnancy suggesting it might play a role in the pathophysiology of PE.

Digibind (Glaxo Smith Kline) is a commercially available FAB fragment, antidigoxin antibody approved for the treatment of digoxin intoxication. In experimental models of hypertension with elevated EDLF levels, Digibind has been shown to lower blood pressure, suggesting that the antibody cross reacts with EDLF. These observations have led to the hypothesis that Digibind might ameliorate some of the manifestations of PE, especially the hypertension. Based on an extensive pre-clinical literature supporting that hypothesis, and encouraging results in 8 cases, a clinical trial is planned to test the effect of Digibind in severe PE. The study is a multi- site, parallel, double blind, placebo controlled, randomized trial. After randomization, 50 patients will be given the usual treatment for severe PE, plus study drug (Digibind or placebo) every six hours, for 48 hours. The study may be terminated during the treatment period for standard indications for early delivery.

Data collection will include: delivery latency, maternal blood pressure, antihypertensive use, renal function, hepatic function, CBC and platelet count, and umbilical artery blood flow by color doppler. Standard maternal and fetal monitoring will be followed. Newborn assessment will include: status at birth, APGAR score, NICU length of stay, respirator use and duration, and any medical complications. Adverse events will be recorded.

Study Design

Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Conditions Intervention Clinical Trials [1631 Associated Clinical Trials listed on BioPortfolio ]

Digoxin is the primary cardiac glycoside in clinical use. Because of the narrow therapeutic index and risk of toxicity, therapeutic drug monitoring is highly recommended. In Egypt, most ca.

The aim of this trial is to investigate the effect of multiple doses of flibanserin on the single dose pharmacokinetics of digoxin in healthy female and male volunteers. Digoxin is a narro.

This is a randomized, double-blind, multi-centered study to compare 6 months of medical treatment with digoxin or propranolol in infants with SVT Background: SVT is the most common sustain.

This study has been designed to confirm, in healthy subjects, the lack of a clinically important pharmacokinetic interaction between Dimebon, at the proposed maximum commercial dose of 20.

This Phase I, open-label, sequential, single-center study evaluates the pharmacokinetics of digoxin when coadministered with albiglutide in healthy adult subjects.

PubMed Articles [13577 Associated PubMed Articles listed on BioPortfolio ]

Digoxin-specific antibody fragments (DSFab) are used for the treatment of poisoning by cardiac glycosides, such as pharmaceutical digoxin. Dosing of this therapy for chronic and acute poisonings is ba.

Digoxin, a major medication for heart disease, was recently reported to have immunosuppressive capacity. Here, we determined the immunosuppressive capacity of digoxin on the development of experimenta.

Half-antibody fragments are a promising reagent for biosensing, drug-delivery and labeling applications, since exposure of the free thiol group in the Fc hinge region allows oriented reaction. Despite.

For decades, digoxin has been widely used to control ventricular rate in atrial fibrillation (AF). However, it remains controversial as to whether digoxin is associated with increased mortality in AF.

Digoxin is still commonly used in atrial fibrillation (AF) patients with and without heart failure (HF) for heart rate control. Studies concerning the detrimental effects of digoxin therapy in AF pati.

Medical and Biotech [MESH] Definitions

A cardiac glycoside sometimes used in place of DIGOXIN. It has a longer half-life than digoxin; toxic effects, which are similar to those of digoxin, are longer lasting. (From Martindale, The Extra Pharmacopoeia, 30th ed, p665)

Alpha- or beta-acetyl derivatives of DIGOXIN or lanatoside C from Digitalis lanata. They are better absorbed and longer acting than digoxin and are used in congestive heart failure.

3 beta,12 beta,14-Trihydroxy-5 beta-card-20(22)-enolide. A cardenolide which is the aglycon of digoxin. Can be obtained by hydrolysis of digoxin or from Digitalis orientalis L. and Digitalis lanata Ehrh.

A semisynthetic digitalis glycoside with the general properties of DIGOXIN but more rapid onset of action. Its cardiotonic action is prolonged by its demethylation to DIGOXIN in the liver. It has been used in the treatment of congestive heart failure (HEART FAILURE).

A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)

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Digibind (Digoxin-specific Fab fragments) Drug

Digibind

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. This page contains answers to some common questions about Digibind. It does not contain all the information that is known about Digibind. It does not take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Your doctor has weighed the risk of you using this medicine against the benefits he/she expects it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. Bookmark or print this page, you may need to read it again.

What is Digibind Injection used for?

Digibind Injection is an antidote used to treat life-threatening digoxin or digitoxin overdose.

Digibind Injection belongs to a group of medicines called the antigen binding fragments.

Digibind is a sterile freeze-dried powder of antigen binding fragments (Fab) obtained from antidigoxin antibodies raised in sheep.

The Fab fragments react with digoxin or digitoxin in the blood to prevent death from digoxin/digitoxin overdose.

Your doctor may have prescribed Digibind Injection for another reason.

Digibind Injection is not addictive.

Before you are given Digibind Injection Digibind Injection should not be used if:

the expiry date (EXP) printed on the pack has passed.

the packaging is torn or shows signs of tampering

Tell your doctor if:

Where possible, tell your doctor if:

you have ever had an allergic reaction to digoxin-specific Fab fragments or any of the ingredients listed toward the end of this leaflet.

you are allergic to foods, dyes, preservatives or any other medicines.

you have received Digibind Injection previously.

you have ever had an allergic reaction to papain, chymopapain or other papaya extracts.

you have previously received antibodies or Fab fragments obtained from sheep.

you have kidney disease.

you are taking any other medicines, including medicines you buy without a prescription.

you are breastfeeding, pregnant or trying to become pregnant.

How Digibind Injection is given

Digibind Injection will be given under the supervision of a doctor.

Digibind is given into your vein after being made up with sterile water for injections.

Your doctor will decide what dose you will receive.

The dose varies depending on the amount of digoxin in your blood that needs to be neutralised and your body weight. The Product Information leaflet provided in the carton explains this information to your doctor.

What do I do if I receive too much? (Overdose)

As Digibind Injection is given to you under the supervision of your doctor, it is unlikely that you will receive too much. However, if you experience any side effects after being given Digibind Injection, tell your doctor immediately.

While you are being given Digibind Injection Things to be careful of

Digibind Injection can lower the potassium levels in your blood. For this reason, the potassium levels in your blood should be closely monitored, particularly during the first few hours after Digibind Injection has been given.

What are the side effects?

Check with your doctor as soon as possible if you think you are experiencing any side effects or an allergic reaction after receiving Digibind Injection, even if the problem is not listed below.

Like other medicines, Digibind Injection can cause some side effects. If they occur, they are most likely to be minor and temporary. However, some may be serious and need medical attention.

The most commonly reported side-effect is low potassium concentration.

In some cases, poor heart function may be worsened because the effects of digoxin has been neutralised.

Rarely, allergic reactions (eg. swelling at injection site, swelling of the face, rash) have occurred.

Tell your doctor immediately if you notice any of the following:

Wheezing, swelling of the lips/mouth, difficulty in breathing, hayfever, lumpy rash (hives) or fainting. These could also be symptoms of an allergic reaction.

This is not a complete list of all possible side effects. Others may occur in some people and there may be some side effects not yet known.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

How do I store Digibind Injection?

Keep this medicine where children cannot reach it, such as in a locked cupboard.

Digibind Injection should be stored in a fridge at 2 degrees C to 8 degrees C. Do not freeze. Protect from light.

Lanoxin (Digibind) Delivery

Residents of the USA can order Lanoxin (Digibind) to any city, to any address, for example to Arlington, New York, Atlanta or Houston. You can order delivery of a Lanoxin (Digibind) to the Australia, Puerto Rico, Norway or any other country in the world.