Snake venom antisera: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Intravenous
Envenomation caused by snake bites

Adult: Doses are based according to species of snake, severity of signs and symptoms, and tolerance of the patient. For the treatment of North American coral snake bite: Usual recommended initial dose: 3-5 vials by slow inj, additional vials may be given as necessary. For the treatment of North American crotalid snake bite: Recommended initial dose: 4-6 vials, additional vials may be given as necessary. Upon stabilization, 2 vials 6 hourly may be given. For the treatment of tiger snake, black snake, brown snake, sea snake, death adder, and taipan bite: Initially, 1 vial via IV infusion. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Child: Same as adult dose.

Reconstitution

North American Coral snake venom antisera: Reconstitute with 10 mL of sterile water for injection. To ensure proper reconstitution, diluent should be directed at the center of the pellet. Swirl the vial for 1 minute at 5 minute intervals, reconstitution takes approx 30 minutes per vial. North American crotalid snake venom antisera: Reconstitute with 18 mL of 0.9% NaCl and mix by continuous manual inversion at the rate of 1-2 inversions per second until no solid material is visible in the vial. Further dilute with 0.9% NaCl to a total volume of 250 mL. Tiger snake, black snake, brown snake, sea snake, death adder, and taipan snake venom antisera: Dilute with 0.9% NaCl or Lactated Ringer’s solution. Instructions for dilution vary depending on the kind of snake venom antisera and country of use, refer to specific product guidelines.

Contraindications

Concurrent use with opioids or other analgesics that suppress respiration.

Special Precautions

Patient with asthma, hay fever, or urticaria. Hypersensitivity to horses or horse-based products; papaya or papain (North American crotalid antivenin). Not for prophylactic use in asymptomatic patient. Pregnancy and lactation.

Adverse Reactions

Significant: Hypersensitivity reactions (e.g. anaphylaxis), delayed serum sickness.
Cardiac disorders: Chest pain.
Gastrointestinal disorders: Nausea, vomiting, abdominal pain, diarrhoea.
General disorders and administration site conditions: Local injection site reactions, pyrexia, chills.
Musculoskeletal and connective tissue disorders: Myalgia.
Nervous system disorders: Headache.
Skin and subcutaneous tissue disorders: Rash, urticaria.

Monitoring Parameters

Monitor the emergence of symptoms of hypersensitivity reactions; resolution of symptoms of envenomation. Monitor respiratory function and oxygenation; urine for hemoglobinuria.

Drug Interactions

May prolong and potentiate the severity of acute anaphylaxis with β-blockers.
Potentially Fatal: May increase the risk of respiratory depression with opioids.

Action

Description:
Mechanism of Action: Snake venom antisera is prepared from the plasma of animals such as horses and sheep immunised with the venom of snakes. It contains a standardized amount of specific antibodies that bind to venom fractions, thereby neutralising its activity and promoting clearance.

Storage

Store between 2-8°C. Do not freeze.

MIMS Class

Vaccines, Antisera & Immunologicals

ATC Classification

J06AA03 - snake venom antiserum ; Belongs to the class of immune sera. Used in the treatment of acute infectious diseases caused by toxigenic strains.

References

Anon. Antivenin (Micrurus fulvius) (Equine). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 26/11/2020.

Anon. Antivenin (Micrurus fulvius). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 25/11/2020.

Buckingham R (ed). Snake Venom Antisera. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 25/11/2020.

Crofab Injection, Powder, Lyophilized, for Solution (BTG International Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 26/11/2020.

North American Coral Snake Antivenin (Equine) Injection, Powder, for Solution (Wyeth Pharmaceuticals LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 26/11/2020.

Disclaimer: This information is independently developed by MIMS based on Snake venom antisera from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com