TABLE 134.5.2.
Guide to initial dosage of some important antivenoms
| Species |
Manufacturer, antivenom | Approximate initial dose | |
|---|---|---|---|
| Latin name | English name | ||
| Acanthophis spp. | Death adder | CSL*, monospecific | 3000–6000 units |
| Bitis arietans | Puff adder | Sanofi-Pasteur, Fav Afrique and Favi Rept, SAVP†; polyspecific | 80 ml |
| Bothrops asper | Terciopelo | Instituto Clodomiro Picado | 50–100 ml |
| Bothrops atrox | Common lance-head | Suero Antiofidico (Instituto Nacional de Higiene y Medicina Tropical “Leopoldo Izquieta Perez” Guayaquil, Ecuador); Soro Antibotropico (Instituto Butantan, San Paulo, Brazil) | 20 ml |
| Bothrops (Bothriopsis) bilineatus | As above | 20 ml | |
| Bothrops jararaca | Jararaca | Instituto Butantan and other Brazilian manufacturers, Bothrops polyspecific | 20 ml |
|
Bungarus caeruleus Bungarus candidus |
Common krait Malayan krait |
Indian manufacturers§, polyspecific Thai Red Cross, Bangkok monospecific |
100 ml 100 ml |
| Calloselasma (Agkistrodon) rhodostoma | Malayan pit viper | Thai Red Cross, Bangkok, monospecific or hemato-polyvalent | 100 ml |
| Crotalus adamanteus | Eastern diamondback rattlesnakes | Protherics “CroFab” | 7–15 vials |
| Crotalus atrox | Western diamondback rattlesnakes | Protherics “CroFab” | 7–15 vials |
| Crotalus oreganus and Crotalus viridis subspp. | Western rattlesnakes | Protherics “CroFab” | 7–15 vials |
| Cryptelytrops (Trimeresurus) albolabris | Green pit viper | Thai Red Cross, monospecific or hemato-polyvalent | 100 ml |
| Daboia (Vipera) palaestinae | Palestine viper | Rogoff Medical Research Institute, Tel Aviv, Palestine, viper-monospecific | 50–80 ml |
| Daboia (Vipera) russelii | Western Russell's viper | Indian manufacturers,§ polyspecific | 100 ml |
| Daboia siamensis | Eastern Russell's viper | Thai Red Cross, monospecific or hemato-polyvalent | 100 ml |
| Myanmar Pharmaceutical Factory monospecific | 50 ml | ||
| Echis ocellatus, Echis leucogaster, Echis pyramidum (Africa) | African saw-scaled or carpet vipers | SAIMR†, Echis, monospecific; Aventis-Pasteur “Fav Afrique” | 20 ml |
| Elapidae (Hydrophiinae) | Sea snakes | CSL*, sea snake | 1000 units |
| Naja kaouthia | Monocellate Thai cobra | Thai Red Cross, monospecific or neuro-polyvalent | 100 ml |
| Naja naja | Indian cobra | Indian manufacturers,§ polyspecific | 100 ml |
| Notechis scutatus | Tiger snake | CSL*, monospecific | 3000–6000 units |
| Oxyuranus scutellatus | Taipan | CSL*, polyspecific | 12,000 units |
| Pseudonaja textilis | Eastern brown snake | CSL*, monospecific | 3000–6000 units |
| Vipera berus | European adder | Immunoloski Zavod-Zagreb Vipera, polyspecific | 10–20 ml |
| Protherics Fab. Monospecific “ViperaTAb” | 100–200 mg | ||
Contacts for procurement of antivenoms: http://www.who.int/bloodproducts/snake_antivenoms/snakeantivenomguide/en/; http://www.searo.who.int/EN/Section10/Section17.htm; http://www.toxinfo.org/antivenoms/ (all websites last accessed 28 December 2011).
*
Commonwealth Serum Laboratories, Melbourne, Australia.
†
South African Vaccine Producers [formerly SAIMR (South African Institute for Medical Research)].
§
Haffkine, Kasauli, Serum Institute of India, Vins, Bharat, Biological Evans, King Institute, etc.