Pralidoxime injection

Generic Name: pralidoxime injection (PRAL i DOX eem)Brand Names: Protopam Chloride

What is pralidoxime injection?

Pralidoxime reverses muscle weakness or paralysis caused by a poison or certain drug overdose.

Pralidoxime is used as an antidote to treat poisoning by a pesticide or by a drug used to treat a muscle disorder.

This medication is not effective as an antidote for all types of pesticide poisonings.

Pralidoxime may also be used for purposes not listed in this medication guide.

What is the most important information I should know about pralidoxime injection?

In an emergency situation, it may not be possible before you are treated with pralidoxime to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

Tell your caregivers at once if you have a fast heart rate, rapid breathing, increased muscle stiffness, or a choking feeling. Do not use any of the following drugs while you are receiving pralidoxime: morphine (Kadian, MS Contin, Oramorph, and others), aminophylline (Truphylline), or theophylline (Elixophyllin, Respbid, Slo-Bid, Theobid, Theo-Dur, and others).

Follow your doctor's instructions about any restrictions on food, beverages, or activity after you receive pralidoxime.

To be sure this medication is helping your condition, your blood will need to be tested. You may also need follow-up appointments after you are released from emergency care. Do not miss any scheduled appointments.

What should I discuss with my health care provider before receiving pralidoxime injection?

Do not use any of the following drugs while you are being treated with pralidoxime:
  • morphine (Kadian, MS Contin, Oramorph, and others);

  • aminophylline (Truphylline); or

  • theophylline (Elixophyllin, Respbid, Slo-Bid, Theobid, Theo-Dur, and others).

If possible, before you receive pralidoxime, tell your doctor if you have kidney disease, or if you are allergic to any drugs. FDA pregnancy category C. This medication may be harmful to an unborn baby. It is not known whether pralidoxime passes into breast milk or if it could harm a nursing baby.

In an emergency situation, it may not be possible before you are treated with pralidoxime to tell your caregivers if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

How is pralidoxime injection given?

This medication is usually given as soon as possible after the poisoning or overdose. You may need to receive pralidoxime for several days.

Pralidoxime is given as an injection into a muscle, under the skin, or through a needle placed into a vein. You will receive this injection in a clinic, hospital, or emergency setting.

After treatment with pralidoxime, you will be watched to make sure the medication has been effective and you no longer have any effects of the poison or drug overdose.

To be sure this medication is helping your condition, your blood will need to be tested. You may also need follow-up appointments after you are released from emergency care. Do not miss any scheduled appointments.

What happens if I miss a dose?

Since pralidoxime is given as needed by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include fast heartbeat, extreme dizziness, and vision problems.

What should I avoid after receiving pralidoxime injection?

Follow your doctor's instructions about any restrictions on food, beverages, or activity after you receive pralidoxime.

Pralidoxime injection side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have any of these serious side effects:
  • fast heart rate;

  • rapid breathing;

  • increased muscle stiffness;

  • a choking feeling;

Less serious side effects may include:

  • pain where the medicine was injected;

  • blurred vision;

  • feeling dizzy or drowsy;

  • headache; or

  • nausea.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Pralidoxime injection Dosing Information

Usual Adult Dose for Anticholinesterase Overdose:

Initial dose: 1 to 2 g IV slowlyMaintenance dose: 250 mg IV every 5 minutes as needed to control symptoms

Usual Adult Dose for Organophosphate Poisoning:

Initial: 600 mg to 2 g IV slowly, IM, or subcutaneouslyMaintenance: 1 to 2 g IV slowly every 1 to 8 hours, or an IV infusion of 500 mg/hr as needed to control symptoms

Usual Pediatric Dose for Anticholinesterase Overdose:

Initial dose:0 to 18 years: 15 to 25 mg/kg IV slowly (up to 1 g)Maintenance dose: