crotalidae (pit viper) polyvalent antivenin (CroFab)

Indications

• pit viper envenomation, North & South American crotalids: rattlesnake, copperhead, cottonmouth, tropical moccasins, fer-delance, bushmaster

Contraindications

• NOT effective against venom of coral snake

pregnancy-category C

safety in lactation ?

Dosage

• IV administration
• local injection not recommended
• initial intradermal skin test prior to administration
  • 1 mL vial of equine serum for sensitivity testing comes with antivenin
• dosage based upon clinical grading of envenomation
  • Grade 0: no antivenin necessary
  • Grade 1: 1-5 vials of antivenin
  • Grade 2: 5-15 vials of antivenin
  • Grade 3: 20+ vials of antivenin
• additional infusions every 2 hours until signs & symptoms have resolved

Pharmacokinetics

elimination: liver

Adverse effects

• hypersensitivity with anaphylaxis may occur in as many as 25% of patients
• serum sickness in 50-75% of patients
  • fever, malaise, arthralgias, lymphadenopathy, morbilliform rash in 7-14 days
• peripheral neuritis (1-10%)

More general terms

• antivenin

More specific terms

• agkistrodon piscivorus antivenin/crotalus adamanteus antivenin/crotalus atrox antivenin/crotalus scutulatus antivenin

Additional terms

• crotalidae (pit viper) polyvalent antivenin (CroFab)
• Crotalidae (pit vipers)
• snakebite