Usual Adult Dose for Botulism

Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) - (Equine):

One vial, diluted, intravenously
Initial infusion rate: 0.5 mL/min for the first 30 minutes; incrementally double infusion rate every 30 minutes if tolerated
Maximum infusion rate: 2 mL/min
Maximum dose: 1 vial

Comments:

• Monitor vital signs throughout infusion.
• Decrease infusion rate for discomfort or infusion related adverse reactions.
• Botulism antitoxin (equine) is available from the Centers for Disease Control via state and local health departments. CDC 24/7 telephone is 770-488-7100.

Use: Treatment of symptomatic botulism after documented or suspected exposure to botulinum neurotoxin serotypes A, B, C, D, E, F, or G

Usual Pediatric Dose for Botulism

Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) - (Equine):

17 years and older: One vial, diluted, intravenously
Initial infusion rate: 0.5 mL/min for the first 30 minutes; incrementally double infusion rate every 30 minutes if tolerated
Maximum infusion rate: 2 mL/min
Maximum dose: 1 vial

1 to 17 years: Infuse dose intravenously
The dosing for children under 17 is weight based and a percentage of the adult dose (1 vial)
Initial infusion rate: 0.01 mL/kg/min for the first 30 minutes; incrementally double infusion rate every 30 minutes if tolerated
Maximum infusion rate: 0.03 mL/kg/min and 2 mL/min
Maximum dose: 1 vial

55 kg and over: 100% of the adult dose
50 to 54 kg: 80% of the adult dose
45 to 49 kg: 75% of the adult dose
40 to 44 kg: 70% of the adult dose
35 to 39 kg: 65% of the adult dose
30 to 34 kg: 60% of the adult dose
25 to 29 kg: 50% of the adult dose
20 to 24 kg: 40% of the adult dose
15 to 19 kg: 30% of the adult dose
10 to 14 kg: 20% of the adult dose
Minimum dose: 20% of the adult dose
Maximum dose: 1 vial (regardless of weight)

Salisbury Rule dosing guide:

• Body weight 30 kg or less: 2 x weight (kg) = % adult dose to administer
• Body weight over 30 kg: weight (kg) + 30 = % adult dose to administer

Under 1 year: 10% of adult dose (regardless of body weight)
Initial infusion rate: 0.01 mL/kg/min for the first 30 minutes; incrementally double infusion rate every 30 minutes if tolerated
Maximum infusion rate: 0.03 mL/kg/min

Comments:

• Monitor vital signs throughout infusion.
• Decrease infusion rate for discomfort or infusion related adverse reactions.
• Botulism antitoxin (equine) is available from the Centers for Disease Control via state and local health departments. CDC 24/7 telephone is 770-488-7100.

Use: Treatment of symptomatic botulism after documented or suspected exposure to botulinum neurotoxin serotypes A, B, C, D, E, F, or G

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Patients at high risk of hypersensitivity reactions: Administer at the lowest rate achievable (under 0.01 mL/min)

Precautions

CONTRAINDICATIONS: None

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For slow intravenous infusion only; dilute before infusion.

Storage requirements:

• Store frozen at or below 5F (-15C) until used.
• Once thawed, may store at 2 to 8 C for a maximum of 36 months or until 48 months from the date of manufacture, whichever comes first. Do not refreeze.

Reconstitution/preparation techniques:

• The manufacturer product information should be consulted.

IV compatibility:

• 0.9% saline solution

Monitoring:

• Monitor vital signs throughout infusion.