Anavip

Drug overview for ANAVIP (antivenin,crotalidae (equine)):

Generic name: antivenin,Crotalidae (equine)
Drug class:
Therapeutic class: Biologicals

Crotalidae immune F(ab')2 (equine) is an antivenin (antivenom) preparation containing equine immunoglobulin G (IgG) F(ab')2 fragments capable of binding and neutralizing venom toxins of North American rattlesnakes (pit vipers).

No enhanced Uses information available for this drug.

DRUG IMAGES

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The following indications for ANAVIP (antivenin,crotalidae (equine)) have been approved by the FDA:

Indications:
Envenomation by pit viper snake (Crotalidae)

Professional Synonyms:
Pit viper snake envenomization
Poisoned bite of pit viper snake
Poisoning due to bite of Crotalidae
Poisoning due to venom of Crotalidae
Poisoning due to venom of pit viper snake
Toxic effect of venom from a pit viper snake

The following dosing information is available for ANAVIP (antivenin,crotalidae (equine)):

Dosing
Administration
Dosing Information
Generic

Dosage of Crotalidae immune F(ab')2 (equine) is expressed in terms of the number of vials of the antivenin.

For the management of envenomation following snakebites involving North American rattlesnakes, the initial dose (number of vials) of Crotalidae immune F(ab')2 (equine), need for additional initial doses to achieve envenomation control, and number of subsequent doses required for maintenance to sustain envenomation control should be based on individual patient response. Age-related dosage adjustments are not indicated. (See Pediatric Use under Warnings/Precautions: Specific Populations, in Cautions.)

The recommended initial dose of Crotalidae immune F(ab')2 (equine) in adults and children is 10 vials. Patients should be monitored during and for at least 1 hour after completion of the initial infusion for allergic reactions and to determine if initial control of envenomation has been achieved (i.e., local manifestations not progressing, systemic symptoms resolved, and coagulation abnormalities normalized or trending towards normalization).

If initial control of envenomation is not achieved after the initial dose, additional 10-vial doses may be administered every 60 minutes as needed.

After initial control of envenomation has been established, patients should be monitored closely for at least 18 hours in a healthcare setting for reoccurrence of coagulation abnormalities. If coagulation abnormalities reoccur, additional 4-vial doses of Crotalidae immune F(ab')2 (equine) are recommended as needed.

The maximum dose of Crotalidae immune F(ab')2 (equine) that can be administered safely is not known.

Crotalidae immune F(ab')2 (equine) is administered by IV infusion.

No dosing information available.

No generic dosing information available.

Moderate List
No disease contraindications

The following adverse reaction information is available for ANAVIP (antivenin,crotalidae (equine)):

Overview
Severe
Less Severe

Adverse reaction overview.

Adverse effects reported in 2% or more of patients receiving Crotalidae immune F(ab')2 (equine) include pruritus, nausea, rash, arthralgia, myalgia, peripheral edema, headache, extremity pain, vomiting, pyrexia, blister, erythema, chills, anxiety, insomnia, and dehydration.

There are 16 severe adverse reactions.

More Frequent	Less Frequent
Anaphylaxis Cough Dyspnea Edema Erythema Facial edema Fatigue Flushing General weakness Laryngeal edema Pruritus of skin Serum sickness Shock Urticaria Vomiting	None.

Rare/Very Rare
Cardiac arrest

There are 0 less severe adverse reactions.

The following precautions are available for ANAVIP (antivenin,crotalidae (equine)):

Pediatric
Pregnant
Lactation
Geriatric

Efficacy and safety of Crotalidae immune F(ab')2 (equine) in pediatric patients are similar to that in adults. In clinical trials of the antivenin, 24% of patients were children 2-16 years of age. Age-related dosage adjustments of antivenin are not indicated since the venom dose following snakebite is expected to be similar in children and adults.

However, the fluid volume used to dilute Crotalidae immune F(ab')2 (equine) may need to be adjusted when the antivenin is used in infants or very small children. (See Reconstitution and Dilution under Dosage and Administration: Administration.)

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

Crotalidae immune F(ab')2 (equine) should be used in pregnant women only when clearly needed. The manufacturer states that it is not known whether Crotalidae immune F(ab')2 (equine) can cause fetal harm when administered to a pregnant woman or whether it can affect fertility. Animal reproduction studies have not been performed with the antivenin.

It is not known whether Crotalidae immune F(ab')2 (equine) is distributed into milk. The manufacturer states that the antivenin should be used with caution in nursing women.

Over 9% of patients in clinical trials were older than 65 years of age, and efficacy of Crotalidae immune F(ab')2 (equine) in these adults was considered comparable to that in the overall patient population.

Envenomation by pit viper snake (crotalidae)
T63.061A	Toxic effect of venom of other north and south american snake, accidental (unintentional), initial encounter
T63.062A	Toxic effect of venom of other north and south american snake, intentional self-harm, initial encounter
T63.063A	Toxic effect of venom of other north and south american snake, assault, initial encounter
T63.064A	Toxic effect of venom of other north and south american snake, undetermined, initial encounter