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Antivenin (Crotalidae) Polyvalent Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

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.

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