digifab_dosing: DigiFab Dosing for Digoxin Poisoning

In cliot: Clinical Indices and Outcomes Tools

DigiFab Dosing for Digoxin Poisoning

Description

Calculates the recommended number of DigiFab (Digoxin Immune Fab) vials for the treatment of digoxin toxicity. The calculator prioritizes dosing based on serum digoxin concentration, followed by the amount ingested (for acute cases), and finally defaults to empiric dosing guidelines if neither is known.

Usage

digifab_dosing(poisoning_type, weight_kg, digoxin_level_ng_ml = NULL,
               amount_ingested_mg = NULL)

Arguments

poisoning_type	String. "acute" or "chronic".
weight_kg	Numeric. Patient weight in kilograms.
digoxin_level_ng_ml	Numeric (Optional). Serum digoxin concentration in ng/mL. This is the preferred method for calculation.
amount_ingested_mg	Numeric (Optional). Estimated amount of digoxin ingested in milligrams. Used for acute cases if serum level is unknown.

Value

A list containing:

Recommended_Vials	The calculated number of vials (rounded up to the nearest whole number).
Total_Dose_mg	The total dose in milligrams (40 mg per vial).
Calculation_Method	The method used to determine the dose (Serum Level, Amount Ingested, or Empiric).

References

DigiFab [package insert]. King of Prussia, PA: BTG International Inc; 2017. Antman EM, Wenger TL, Butler VP Jr, Haber E, Smith TW. Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. Final report of a multicenter study. Circulation. 1990;81(6):1744-1752.

Examples

# Example 1: Known Serum Level
# Chronic toxicity, 70kg, Level 4.0 ng/mL
# Dose = (4 * 70) / 100 = 2.8 -> 3 vials
digifab_dosing("chronic", 70, digoxin_level_ng_ml = 4.0)

# Example 2: Acute Ingestion (Unknown Level)
# Acute, 60kg, Ingested 10 mg
# Dose = 10 * 1.6 = 16 vials
digifab_dosing("acute", 60, amount_ingested_mg = 10)

# Example 3: Empiric Acute
# Acute, 80kg, Unknown details
# Dose = 10 vials (Empiric)
digifab_dosing("acute", 80)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.