Life-threatening digoxin intoxication
Dosage for acute ingestion of known amounts of digoxin or digitoxin
- Dosage varies according to the amount of digoxin or digitoxin to be neutralized
- Each vial neutralizes approximately 0.5 mg of digoxin
- Total number of vials required can be calculated by dividing the total body load of digoxin in milligrams by 0.5 mg per vial
- Alt: 10 vials IV x1 for 25 tabs/caps ingested acutely
- Therapy may be given as 10-20 vials IV x1 if the amount of digoxin ingested is unknown
- If toxicity is not adequately reversed after several hours, or if it appears to recur, additional therapy administration at a dose guided by clinical judgment may be required
Dosage based on steady-state serum digoxin concentrations (dosage for toxicity during chronic therapy)
- Dosage may vary according to the amount of digoxin or digitoxin to be neutralized
- No. of vials IV = Serum digoxin concentration in ng/mL x weight in kg/100; may be given as 6 vials IV x1 if serum digoxin levels are not available
- No. of vials IV = Serum digitoxin concentration in ng/mL x weight in kg/1000
Note:
- Therapy should be administered slowly as an intravenous infusion over at least 30 minutes; may be given by bolus injection if cardiac arrest is imminent
Life-threatening digoxin intoxication
Dosage for acute ingestion of known amounts of digoxin or digitoxin
- Dosage varies according to the amount of digoxin or digitoxin to be neutralized
- Each vial neutralizes approximately 0.5 mg of digoxin
- Total number of vials required can be calculated by dividing the total body load of digoxin in milligrams by 0.5 mg per vial
- Alt: 10 vials IV x1 for 25 tabs/caps ingested acutely
- Therapy may be given as 10-20 vials IV x1 if the amount of digoxin ingested is unknown; monitor volume overload in small children
- If toxicity is not adequately reversed after several hours, or if it appears to recur, additional therapy administration at a dose guided by clinical judgment may be required
Dosage based on steady-state serum digoxin concentrations (dosage for toxicity during chronic therapy)
- Dosage may vary according to the amount of digoxin or digitoxin to be neutralized
- Infants and children =<20 kg
- No. of vials IV = Serum digoxin concentration in ng/mL x weight in kg/100; may be given as a single vial IV if serum digoxin level is not available
- No. of vials IV = Serum digitoxin concentration in ng/mL x weight in kg/1000
Note:
- Because infants and small children have much smaller dosage requirements, it is recommended that the 40-mg vial be reconstituted as directed and administered with a tuberculin syringe
- Therapy should be administered slowly as an intravenous infusion over at least 30 minutes; may be given by bolus injection if cardiac arrest is imminent
