Pralidoxime Side Effects

It is possible that some side effects of pralidoxime may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to pralidoxime: injection injectable, injection powder for solution

As well as its needed effects, pralidoxime may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking pralidoxime, check with your doctor or nurse immediately:

More common
  • Blurred or double vision
  • change in near or distance vision
  • difficult or rapid breathing
  • difficulty in focusing the eyes
  • difficulty with speaking
  • dizziness
  • fast, pounding, or irregular heartbeat or pulse
  • muscle stiffness or weakness
  • pain at the injection site (after injection into a muscle)
Incidence not known
  • Deep or fast breathing with dizziness
  • numbness of the feet, hands, and around the mouth

Some pralidoxime side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Drowsiness
  • headache
  • nausea

For Healthcare Professionals

Applies to pralidoxime: intravenous powder for injection

General

Pralidoxime has been well tolerated in most cases; however, it should be considered that the desperate condition of the organophosphate-poisoned patient generally masks the minor signs and symptoms noted in normal subjects who have not been exposed to anticholinesterase poisons. Many of the signs and symptoms of organophosphate poisoning are similar to the side effects of pralidoxime. It may be difficult to ascertain which effects are due to the drug and which are toxic symptoms produced by atropine or the organophosphate compounds.

Cardiovascular

Cardiovascular side effects have included tachycardia and increased systolic and diastolic blood pressure in normal subjects. Tachycardia has also occurred after excessively rapid infusions. Asystole and cardiac arrest have been reported; however, causality is unclear due to the presence of atropine and an organophosphate insecticide.

Musculoskeletal

Musculoskeletal side effects have included muscle weakness in normal subjects. Laryngospasm and muscle rigidity have occurred after excessively rapid infusions.

Nervous system

Nervous system side effects have included dizziness, headache, and drowsiness in normal subjects.

Respiratory

Respiratory side effects have included hyperventilation in normal subjects.

Ocular

Ocular side effects have included blurred vision, diplopia, and impaired accommodation in normal subjects.

Gastrointestinal

Gastrointestinal side effects have included nausea in normal subjects.

Metabolic

Metabolic side effects have included transient elevations of creatine phosphokinase in all normal subjects.

Hepatic

Hepatic side effects have included elevations of AST and/or ALT in normal subjects.

Elevated AST and/or ALT were reported in 1 of 6 normal subjects given 1200 mg intramuscularly and 4 of 6 normal subjects given 1800 mg intramuscularly. Levels returned to normal in about 2 weeks.

Local

Local side effects have included mild to moderate injection site pain, 40 to 60 minutes after intramuscular injection.

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