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Prescribing Information
Important Safety Information
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Strike Back Overview

Welcome to Strike Back Environmental Education

Our mission is to provide educational information and resources to help you prepare the best treatment possible at every stage of a pit viper envenomation.

Prepare, Protect, Perform.

How to Treat a Snakebite

Use the interactive guide with step-by-step instructions on how to treat a snakebite.

Launch Algorithm

Review resources on the treatment algorithm for the management of crotaline snakebites.

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Achieving Control

Learn about resolving all 3 critical components of pit viper envenomation in order to achieve initial control.

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Myths About Treatment

Find out which common treatment myths to avoid when treating North American pit viper envenomation.

Review Myths
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Snakes in Your State

Learn which snakes you may encounter in your area by visiting our interactive map.

View Map
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About Pit Viper Envenomation

Learn about the impact North American pit viper envenomation can have on your patients.

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Understand the Risk for North American Pit Viper Envenomation and Know How to Act Quickly

Since the consequences of pit viper envenomation may be severe, it’s important to understand the impact of venom on the patient and follow an established treatment protocol.

According to the Department of Wildlife Ecology and Conservation at the University of Florida, approximately 8000 venomous snakebites occur each year in the United States. 

The number of envenomations reported to poison centers has increased in recent years, and research suggests that many states across the United States will be at even higher risk for snakebites in the future. 

Strike Back Envenomation Education will help you prepare for every stage of a snakebite envenomation.

Did you know?


98% of venomous snakebites in the United States are from the North American pit viper, including copperheads, cottonmouths, and rattlesnakes.  Make sure you're prepared with treatment that covers this entire range.

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Recommendations for the management of North American pit viper envenomation

Launch Treatment Algorithm
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Appropriate dosing achieves initial and sustained control of envenomation 

Learn How to Dose CroFab
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Real-world use supports improved outcomes with CroFab 

Hear Real Patient Experiences
References

  1. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol. 2017;55(10):1072-1252.

  2. Frequently Asked Questions. Department of Wildlife Ecology and Conservation website. Accessed September 13, 2023. Ufwildlife.ifas.ufl.edu/venomous_snake_faqs.shtml

  3. Spiller HA, Bosse GM, Ryan ML. Use of antivenom for snakebites reported to United States poison centers. Am J Emerg Med. 2010;28(7):780-785.

  4. Yanez-Arenas C, Peterson AT, Rodriguez-Medina K, Barve N. Mapping current and future potential snakebite risk in the new world. Clim Change. 2016;134:697-711.

  5. CroFab®. Prescribing information. BTG International Inc.; August 2018.

Indication and Important Safety Information
Indication

CroFab® Crotalidae Polyvalent Immune Fab (Ovine) is a sheep-derived antivenin indicated for the management of adult and pediatric patients with North American crotalid envenomation. The term crotalid is used to describe the Crotalinae subfamily (formerly known as Crotalidae) of venomous snakes which includes rattlesnakes, copperheads and cottonmouths/water moccasins.

Important Safety Information
Contraindications

Do not administer CroFab® to patients with a known history of hypersensitivity to any of its components, or to papaya or papain unless the benefits outweigh the risks and appropriate management for anaphylactic reactions is readily available.

Warnings and Precautions

Coagulopathy: In clinical trials, recurrent coagulopathy (the return of a coagulation abnormality after it has been successfully treated with antivenin), characterized by decreased fibrinogen, decreased platelets, and elevated prothrombin time, occurred in approximately half of the patients studied; one patient required re-hospitalization and additional antivenin administration. Recurrent coagulopathy may persist for 1 to 2 weeks or more. Patients who experience coagulopathy due to snakebite should be monitored for recurrent coagulopathy for up to 1 week or longer. During this period, the physician should carefully assess the need for re-treatment with CroFab® and use of any type of anticoagulant or anti-platelet drug.

Hypersensitivity Reactions: Severe hypersensitivity reactions may occur with CroFab®. In case of acute hypersensitivity reactions, including anaphylaxis and anaphylactoid reactions, discontinue infusion and institute appropriate emergency treatment. Patients allergic to papain, chymopapain, other papaya extracts, or the pineapple enzyme bromelain may also have an allergic reaction to CroFab®. Follow-up all patients for signs and symptoms of delayed allergic reactions or serum sickness (e.g., rash, fever, myalgia, arthralgia).

Adverse Reactions

The most common adverse reactions (incidence ≥ 5% of subjects) reported in the clinical studies were urticaria, rash, nausea, pruritus and back pain. Adverse reactions involving the skin and appendages (primarily rash, urticaria, and pruritus) were reported in 12 of the 42 patients. Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment and one patient discontinued CroFab® due to an allergic reaction. Recurrent coagulopathy due to envenomation and requiring additional treatment may occur.

Please see full Prescribing Information.