Drug Class: Antitoxins and antivenins
Usual Adult Dose for Venomous Snake Bite
Initial dose: 4 to 6 vials, IV, over 60 minutes: at 25 to 50 mL/hour the first 10 minutes - if no allergic reaction, may increase rate to 250 mL/hour
Continue administering 4 to 6 vials, IV, over 60 minutes, every 6 hours for up to 18 hours, until initial control of envenomation is achieved
Maintenance dose (after initial envenomation control is achieved): 2 vials, IV, every 6 hours for up to 18 hours (3 doses); additional 2 vial doses may be given as deemed necessary based on the patient's clinical course
Comments:
- Administer as soon as possible after snakebite in patients with signs of progressive envenomation (e.g. worsening local injury, coagulation abnormality, or systemic envenomation signs).
- Early use (within 6 hours of snakebite) is advised to prevent clinical deterioration and systemic coagulation abnormalities.
- Closely monitor patients for allergic reactions during the infusion.
- Observe the patient for up to 1 hour after the first dose to determine if initial control has been achieved.
Usual Pediatric Dose for Venomous Snake Bite
Initial dose: 4 to 6 vials, IV, over 60 minutes: at 25 to 50 mL/hour the first 10 minutes - if no allergic reaction, may increase rate to 250 mL/hour
Continue administering 4 to 6 vials, IV, over 60 minutes, every 6 hours for up to 18 hours, until initial control of envenomation is achieved
Maintenance dose (after initial envenomation control is achieved): 2 vials, IV, every 6 hours for up to 18 hours (3 doses); additional 2 vial doses may be given as deemed necessary based on the patient's clinical course
Comments:
- Administer as soon as possible after snakebite in patients with signs of progressive envenomation (e.g. worsening local injury, coagulation abnormality, or systemic envenomation signs).
- Early use (within 6 hours of snakebite) is advised to prevent clinical deterioration and systemic coagulation abnormalities.
- Closely monitor patients for allergic reactions during the infusion.
- Observe the patient for up to 1 hour after the first dose to determine if initial control has been achieved.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dialysis
Data not available
Other Comments
Storage requirements:
- Refrigerate; do not freeze
Reconstitution/preparation techniques:
- Reconstitute each vial with 18 mL of 0.9% saline.
- Mix by continuous manual inversion until no solid material is visible.
- Do not shake.
- Further dilute the contents of all reconstituted vials in 250 mL of 0.9% saline, mix by gently swirling.
- Use reconstituted product within 4 hours.
General:
- Supportive measures are often used for pain, swelling, hypotension, and wound infections from snakebite.
- Poison control centers are helpful for individual treatment advice.
