→ immunotherapy used for digoxin therapy → By binding it facilitates dissociation of digoxin from sodium potassium aTPase. combines free digoxin then the digoxin is easily excreted through renal secretion. → Effective acute or severe chronic digitoxicity, life-threatening tachyarrhythmia or bradyarrhythmia, patient with hyperkalemia with potassium level less than 6 mmol/L, renal failure, hemodynamic instability with digoxin concentration of more than 2 mcg/L. → Acute ingestion of digoxin. → Adult more than 10 mg → children more than 4 mg → 1 vial binds 0.5 mg of digoxin. If unknown ingestion, administer 10 vials for adults and 5 vials for children