antivenin, Centruroides (scorpion) (Rx)

Brand and Other Names:Anascorp
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • <120mg total protein and >150 LD50 [mouse] neutralizing units/vial
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Centruroides (Scorpion) Envenomation

Centruroides (scorpion) immune F(ab')2 (equine) injection; antivenom indicated for treatment of clinical signs of scorpion envenomation

Initiate treatment as soon as possible in patients who develop clinically important signs of scorpion envenomation, including but not limited to loss of muscle control, roving or abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth, and vomiting

Initial dose: Infuse contents of 3 vials IV over 10 minutes (see IV preparation); monitor for up to 60 minutes after completing infusion to determine if symptoms are resolved

Additional doses may be used if needed; infuse 1 vial at a time at 30-60 minutes intervals

Renal Impairment

Dose adjustment not listed by manufacturer

Hepatic Impairment

Dose adjustment not listed by manufacturer

Dosage Forms & Strengths

powder for injection

  • <120mg total protein and >150 LD50 [mouse] neutralizing units/vial
more...

Centruroides (Scorpion) Envenomation

Centruroides (scorpion) immune F(ab')2 (equine) injection; antivenom indicated for treatment of clinical signs of scorpion envenomation

Initiate treatment as soon as possible in patients who develop clinically important signs of scorpion envenomation, including but not limited to loss of muscle control, roving or abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth, and vomiting

Initial dose: Infuse contents of 3 vials IV over 10 minutes (see IV preparation); monitor for up to 60 minutes after completing infusion to determine if symptoms are resolved

Additional doses may be used if needed; infuse 1 vial at a time at 30-60 minutes intervals

Note: Most of the patients treated in clinical trials were children (78%), ranging in age from <1 month to 18.7 years

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Adverse Effects

1-10%

Vomiting (4.7%)

Pyrexia (4.1%)

Rash (2.7%)

Nausea (2.1%)

Pruritus (2%)

Headache (1.9%)

Rhinorrhea (1.8%)

Myalgia (1.6%)

Fatigue (1.6%)

Cough (1.4%)

Diarrhea (1.3%)

Lethargy (1.1%)

<1%

Serum sickness (0.5%)

Postmarketing Reports

Chest tightness

Palpitation

Eye edema

Respiratory distress

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Warnings

Contraindications

None listed by manufacturer

Cautions

Severe hypersensitivity reactions, including anaphylaxis, are possible; prepare for monitoring and management of allergic reactions, particularly with a history of hypersensitivity to equine proteins or who have received previous antivenins containing equine proteins

Readiness with IV therapy using epinephrine, corticosteroids, and diphenhydramine is recommended during the infusion

Delayed allergic reactions (serum sickness, 0.5% incidence) may occur; monitor with follow-up visit

Made from equine plasma and may contain infectious agents (eg, viruses)

Localized reactions and generalized myalgias reported with cresol, as an injectable excipient contained in Anascorp

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Pregnancy & Lactation

Pregnancy Category: C; No human or animal data exist; use only if clearly needed

Lactation: Unknown whether distributed in breast milk; caution advised

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Composed of venom-specific F(ab’)2 fragments of immunoglobulin G (IgG) that bind and neutralize venom toxins, facilitating redistribution away from target tissues and elimination from the body

Pharmacokinetics

AUC: 706 mcg•hr/mL

Vd (steady-state): 13.6 L

Onset (time to resolution of symptoms): 1.91 hr (adults); 1.28 hr (children); 4 hr (>95% of patients)

Half-life: 159 hr

Clearance: 83.5 mL/hr

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Administration

IV Preparation

Reconstitute contents of each vial with 5 mL of sterile normal saline and mix by continuous gentle swirling

Initial infusion (ie, 3 vials): Combine contents of reconstituted vials promptly and further dilute to a total volume of 50 mL with sterile normal saline

Additional doses: Further dilute reconstituted vial to total volume of 50 mL with sterile normal saline

Inspect solution visually for particulate matter and discoloration prior to administration; do not use if turbid

IV Administration

Infuse IV over 10 minutes

Monitor patient closely during and up to 60 minutes following completion of infusion to determine if clinically important signs of envenomation have resolved

Storage

Available as a sterile, lyophilized preparation in a single-use vial

Store at room temperature (up to 25 ºC [77 ºF])

Temperature excursions are permitted up to 40 ºC (104ºF)

Do not freeze

Discard partially used vials

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
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  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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