With any venomous North American pit viper bite, coagulation abnormalities may persist or recur even after initial control of envenomation.4
Results are from a prospective, open-label, multicenter trial of 31 otherwise healthy patients 10 years of age or older who had suffered from minimal or moderate North American pit viper envenomation that showed evidence of progression. The study compared 2 different dosing schedules. Patients were given an initial intravenous dose of 6 vials of CroFab® with an option to re-treat with an additional 6 vials, if needed, to achieve initial control of the envenomation syndrome. Once initial control was achieved, patients were randomized to receive additional CroFab® either every 6 hours for 18 hours (scheduled group) or as needed (PRN group).
1. CroFab® [prescribing Information]. BTG International Inc; May 2017. 2. 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. 3. Bush SP, Ruha AM, Seifert SA, et al. Comparison of F(ab’)2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial. Clin Toxicol. 2015;53(1):37-45. 4. Boyer LV, Seifert SA, Clark RF, et al. Recurrent and persistent coagulopathy following pit viper envenomation. Arch Intern Med. 1999;159(7):706-710. 5. Schaeffer TH, Khatri V, Reifler LM, Lavonas EJ. Incidence of immediate hypersensitivity reaction and serum sickness following administration of crotalidae polyvalent immune Fab antivenom: A meta-analysis. Acad Emerg Med. 2012;19:121- 131.