For North American Pit Viper Envenomation
Rattlesnakes, Copperheads, Cottonmouths/Water Moccasins
CroFab® Crotalidae Polyvalent Immune Fab (Ovine) is a treatment for the management of patients with North American pit viper envenomation. CroFab® Crotalidae Polyvalent Immune Fab (Ovine) has been clinically proven to halt envenomation progression from venomous North American pit viper bites.
Early use of CroFab® Crotalidae Polyvalent Immune Fab (Ovine) (within 6 hours of snakebite) is advised to prevent clinical deterioration and the occurrence of systemic coagulation abnormalities.
Management of North American
Pit Viper Envenomation
New Video! Watch Sean Bush, MD, FACEP, and A'me Saverino, RN, talk about treating North American pit viper envenomation in the field and in the hospital.
To report an adverse event or for 24-hour medical information, call 1-877-377-3784.References
- Norris RL, Bush SP. Bites by venomous reptiles in the Americas. In: Auerbach PS. Wilderness Medicine. 5th ed. Philadelphia, PA: Mosby Elsevier; 2007: chap 48.
- Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2008 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (Phila). 2009;47:911-1084.
- Tokish JT, Benjamin J, Walter F. Crotalid envenomation: the southern Arizona experience. J Orthop Trauma. 2001;15:5-9.
- Seifert SA, Boyer LV, Benson BE, Rogers JJ. AAPCC database characterization of native U.S. venomous snake exposures, 2001â€“2005. Clin Toxicol (Phila). 2009;47:327-335.
- O'Neil ME, Mack KA, Gilchrist J, Wozniak EJ. Snakebite injuries treated in United States emergency departments, 2001-2004. Wilderness Environ Med. 2007;18:281-287.
- Dart RC. North American Pit Vipers. In: White J and Dart RC, eds. Snakebite: a brief medical guide. Lancaster, PA: Cadmus Communications; 2008:28-45.
CroFab® Crotalidae Polyvalent Immune Fab (Ovine) is indicated for the management of patients with North American crotalid envenomation. The term crotalid is used to describe the Crotalinae subfamily (formerly known as Crotalidae) of venomous snakes that includes rattlesnakes, copperheads, and cottonmouths/water moccasins. Early use of CroFab® Crotalidae Polyvalent Immune Fab (Ovine) (within 6 hours of snakebite) is advised to prevent clinical deterioration and the occurrence of systemic coagulation abnormalities.
Important Safety Information
The most common adverse events reported in clinical studies were mild or moderate reactions involving the skin and appendages (primarily urticaria, rash, or pruritus), which occurred in 14 out of 42 patients. Three patients experienced a serious adverse event. Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment. One patient had a recurrent coagulopathy due to envenomation, which required rehospitalization and additional antivenin administration. In clinical trials, recurrent coagulopathy (the return of a coagulation abnormalityafter 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. Recurrent coagulopathy may persist for 1 to 2 weeks or more. One patient discontinued CroFab® Crotalidae Polyvalent Immune Fab (Ovine) therapy due to an allergic reaction. Patients with allergies to papain, chymopapain, other papaya extracts, or the pineapple enzyme bromelain may also be at risk for an allergic reaction to CroFab® Crotalidae Polyvalent Immune Fab (Ovine).