Antivenin, Eastern and Texas Coral Snakes

Antivenin, eastern and Texas coral snakes are used to treat venomous bites from eastern and Texas coral snakes.

Antivenin, eastern and Texas coral snakes are discontinued.

Antivenin, eastern and Texas coral snakes are available under the following different brand names: Antivenin (Micrurus fulvius).

Dosages of Antivenin, Eastern and Texas Coral Snakes:

Dosage Forms and Strengths

Lyophilized Powder for Injection

• 10mL/vial

Dosage Considerations – Should be Given as Follows:

Envenomations

• SKIN TEST (ID) FIRST (0.02 mL injected intradermally of a 1:10 dilution of Normal Horse Serum or Antivenin and observe for 20 minutes; if wheal/flare response occurs, treat in intensive care unit (ICU) setting)
• Initial: 3-5 vials by slow intravenous (IV) infusion
• Administer initial 1-2 mL over 3-5 minutes either slow IVP or infusion
• 10+ vials may be needed

If the skin test is mildly positive or unsure

• Prepare 1:10 and 1:100 dilutions, and administer as follows if no reaction at each step
• 0.1, 0.2, and 0.5 mL of 1:100 dilution SC every 15 minutes, THEN
• The same amount with 1:10 dilution, THEN
• The same amount with undiluted, THEN
• Switch to intramuscular (IM) and continue doubling the dose every 15 minutes or IV infusion

Additional Information

• Equine-derived antibodies against venom from Eastern and Texas coral snakes; not active against Western Arizona or Sonoran coral snakes
• Arizona poison control center 520-626-6016 (Tucson); Emergency 1-800-222-1222
• Treat allergic reactions with corticosteroids (i.e., Solu-Medrol 125 mg IVP), antihistamines, and epinephrine; may help to slow IV infusion or further dilute antivenom; pretreat if positive skin test
• Empirical recommendation: pretreat with diphenhydramine 25 mg IV and start epinephrine (1:1,000) 1 mg in 250 mL NS drip at a low rate (50 mL/hour) before giving antivenom

Other Indications and Uses

• Micrurus fulvius fulvius (Eastern and Texas coral snake) envenomations
• NOT active against Western Arizona or Sonoran coral snake venom

Side effects of antivenin, eastern and Texas coral snakes include:

• Anaphylaxis (within 30 minutes)
• Bluish or purplish discoloration of the skin
• Swelling of face, tongue, and throat
• Flushing
• Itching
• Hives
• Vomiting
• Wheezing
• Hypersensitivity reaction (Arthus reaction)
• Serum sickness (if more than 8 vials used) (usually 5-24 days after administration)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Antivenin, eastern and Texas coral snakes have no listed severe interactions with other drugs.
• Antivenin, eastern and Texas coral snakes have no listed serious interactions with other drugs.
• Antivenin, eastern and Texas coral snakes have no listed moderate interactions with other drugs.
• Antivenin, eastern and Texas coral snakes have no listed mild interactions with other drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings
This medication contains antivenin, eastern and Texas coral snakes. Do not take Antivenin (Micrurus fulvius) if you are allergic to antivenin, eastern and Texas coral snakes or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• NONE for a life-threatening situation
• Prophylactic use

Effects of Drug Abuse

• No information is available

Short-Term Effects

• See "What Are Side Effects Associated with Using Antivenin, Eastern and Texas Coral Snakes?”

Long-Term Effects

• See "What Are Side Effects Associated with Using Antivenin, Eastern and Texas Coral Snakes?”

Cautions

• Anaphylaxis to horse serum
• Absence of early anaphylaxis no guarantee of later reactions or serum sickness
• Do NOT give concomitant morphine or strong sedatives

Pregnancy and Lactation

• There is no information available regarding the use of antivenin, eastern and Texas coral snakes during pregnancy or while breastfeeding. Consult your doctor.