Appropriate Dosing of CroFab Achieves Initial and Sustained Control of Envenomation1
Snakebite treatment should be administered as soon as possible in patients with any sign of envenomation (e.g., local, systemic, or hematologic effects) to prevent clinical deterioration.1
Administer an initial dose of 4-6 vials* and monitor for signs of progression.
- Administer an additional 4-6 vials if initial control is not achieved ~1 hour after initial dose
- Once initial control is achieved, administer an additional 2 vials every 6 hours for up to 18 hours (total of 3 doses)
- Scheduled maintenance dosing reduced the incidence of coagulation abnormalities due to residual venom1
*Initial dose may vary from 4-12 vials based on clinical judgment and severity of envenomation. Dosing is the same in adult and pediatric patients.1
In pre- and postmarketing studies, 67-88% of patients achieved initial control with an initial dose of 4-6 vials when given according to recommended dosing.2,3
Initial Control Requires Addressing All 3 Components of Envenomation1,4
Progression of edema, ecchymosis, and leading edge of local injury has been arrested
- Patient is normotensive and stable
- Neurotoxicity is resolving or improving
- Nausea, vomiting, dizziness, or tachycardia is resolving
Coagulation abnormalities (e.g., thrombocytopenia, spontaneous bleeding) have normalized or are trending towards normal
Watch Dr. William Banner discuss his approach to dosing antivenom for children.
1. CroFab® [prescribing Information]. BTG International Inc; August 2018. 2. Dart RC, Seifert SA, Boyer LV, et al. A randomized multicenter trial of crotalinae polyvalent immune Fab (ovine) antivenom for the treatment for crotaline snakebite in the United States. Arch Intern Med. 2001;161(16):2030-2036. 3. Lavonas EJ, Gerardo CJ, O'Malley G, et al. Initial experience with Crotalidae polyvalent immune Fab (ovine) antivenom in the treatment of copperhead snakebite. Ann Emerg Med. 2004;43(2):200-206. 4. Lavonas EJ, Ruha AM, Banner W, et al. Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop. BMC Emerg Med. 2011;11:2.