Antivenom Injection 10ml

Antivenom Injection (Snake Venom Antiserum)

Generic: Snake Venom Antiserum
Manufacturer: Incepta Pharmaceuticals Ltd.
Dosage Form: Lyophilized Powder for Injection (IV Infusion)
Pack Size: 10 ml vial

Composition

Each vial contains lyophilized Snake Venom Antiserum. After reconstitution, each ml neutralises:

• Cobra venom (Naja naja) — not less than 0.60 mg
• Common Krait venom (Bungarus caeruleus) — not less than 0.45 mg
• Russell's Viper venom (Vipera russelli) — not less than 0.60 mg
• Saw-Scaled Viper venom (Echis carinatus) — not less than 0.45 mg

Also contains the antimicrobial agent cresol.

Description

Antivenom is a refined and concentrated preparation of serum globulins containing equine immunoglobulin fragments F(ab')₂, obtained from the plasma of healthy equines hyperimmunised against the venoms of the above four snake species. It is the only specific antidote for envenomation by these snakes.

Indications

Antivenom is indicated for confirmed or strongly suspected envenomation by Cobra (Naja naja), Common Krait (Bungarus caeruleus), Russell's Viper (Vipera russelli), or Saw-Scaled Viper (Echis carinatus), when one or more of the following clinical signs are present:

Local envenomation:

• Bite marks with or without oozing of blood, blistering, or skin discolouration
• Rapidly progressive or massive swelling involving more than half of the bitten limb within a few hours of the bite (without tourniquet)
• Enlarged, tender regional lymph nodes within a few hours of the bite

Systemic envenomation:

• Neurotoxic syndrome: Blurring or double vision, dysphagia, drowsiness, ptosis, slurred speech, ataxia, shallow breathing, respiratory paralysis, or generalised flaccid paralysis
• Haemotoxic syndrome: Spontaneous systemic bleeding, nausea, vomiting, abdominal pain, signs of GI or retroperitoneal bleeding, renal damage, coagulopathy detected by 20-minute whole-blood clotting test (WBCT), or shock

First Aid Before Administration

• Move the patient to a well-ventilated, quiet place; restrict movement
• Immobilise the bitten limb below heart level using a splint bandage (as for a fracture)
• Avoid tourniquets; if already applied, release slowly only after Antivenom infusion has started
• Transfer to the nearest medical facility immediately — do not delay

Reconstitution

Transfer the contents of the supplied diluent into the vial containing the lyophilized preparation. Gently swirl to mix — avoid vigorous shaking. Use immediately after reconstitution.

Dosage & Administration

Route: Slow intravenous (IV) infusion only. IM or local injection around the bite wound is NOT recommended.

Initial dose: 5–10 vials administered by slow IV infusion, either:

• Undiluted at ≤2 ml/minute, or
• Diluted in normal saline or glucose saline at 5–10 ml/kg body weight over 1 hour

Children receive the same dose as adults.

Monitoring: Vital signs must be monitored continuously during the first hour of infusion. Adrenaline should be kept ready at the bedside before starting infusion.

Further dosing:

• For haemotoxic bites: if blood remains incoagulable at 6 hours post-infusion (WBCT), administer a further 5–10 vials IV
• For neurotoxic bites: if no reversal of paralysis at 1 hour, administer a further 5–10 vials IV
• Total dose in most cases: 15–20 vials is adequate

Note: Hypersensitivity skin tests have no predictive value and should not be used.

Contraindications

There are no absolute contraindications. Pregnancy is not a contraindication given the life-threatening risk of snake envenomation.

Warnings & Precautions

• Being of equine origin, Antivenom can cause early (anaphylaxis) or late (serum sickness) hypersensitivity reactions
• Always have Inj. Adrenaline 0.25 ml ready before starting infusion
• Adequate dilution and controlled infusion rate reduce adverse reaction risk
• In haemotoxic bites, avoid IM injections until coagulopathy is corrected (risk of haematoma)
• Use with extra caution in patients with known hypersensitivity to equine products or a history of horse serum exposure
• β-adrenergic blockers increase the risk of severe acute anaphylaxis — use with caution in patients on such therapy

Side Effects

Reactions are due to the heterologous (equine) nature of the antiserum:

• Early: Anaphylaxis (urticaria, bronchospasm, hypotension) — treat immediately with Adrenaline
• Late (Serum Sickness): Fever, rash, arthralgia, lymphadenopathy — typically occurring 5–14 days after infusion

Storage

Lyophilized Antivenom is stable at room temperature and does not require cold storage. Ideally store in a cool, dark place away from excessive heat and direct sunlight.

Disclaimer: This product information is for reference purposes only and does not substitute professional medical advice, diagnosis, or treatment. Always consult a registered physician or qualified healthcare professional before taking any medication.