Scorpion Venom Antiserum

Registered South African indications:

• Parabuthus family Buthidae scorpion stings

Contraindications

• Hypersensitivity to the active ingredient or to any of its excipients
• Hypersensitivity to horse serum
• Significant allergic disease

Cautions

• Pregnancy
• Allergic disposition
• Asthma
• Infantile eczema

Forms avail. in SA and covered in this monograph: inj

Parabuthus scorpion stings

• IV (inj): Initial: 10ml, bolus given as a slow injection over 3-5mins or, as an infusion over 5-10mins; Give further 5ml after 4-6hrs if needed

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The intramuscular route should only be considered if IV administration is not possible

Only give antivenom if there are signs of neurotoxicity such as numbness in the mouth or other systemic signs and symptoms such as muscle cramps

 Can give antivenom even if a few days after the sting – especially if initial symptoms persist or worsen

See adult dosage

Pregnancy

• Antivenom use is not contraindicated in pregnancy, consider risk versus benefit

Breastfeeding

• Compatible
• It is safe to use in breastfeeding mothers

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Fatigue
• Headache

Cardiovascular Disorders

• Palpitations

Respiratory Disorders

• Rhinorrhoea
• Cough
• Aspiration
• Ataxia
• Chest tightness
• Hypoxia
• Pneumonia
• Respiratory distress

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea

Musculoskeletal Disorders

• Myalgia
• Periarticular oedema
• Polyarthritis

Skin and Subcutaneous Tissue Disorders

• Skin rash
• Pruritus
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Fever
• Hypersensitivity reactions 
• Anaphylactic reactions
• Serum sickness
• Lymphadenopathy

Sensory Disorders

• Ocular oedema

No known significant interactions

• Vital signs
• Respiratory function

Administration directions

• IV infusion: Diluents include: normal saline, 5% dextrose water
• Allow antiserum to run in over 30 min (takes 2 - 6 hrs to reach peak effect), then administer an additional ampule later if necessary

Other Information

• Local pain, without systemic symptoms and signs of envenomation, is not an indication for antivenom administration
• Scorpionism (systemic symptoms and signs of scorpion envenomation) is sometimes difficult to distinguish from latrodectism. Consult the Tygerberg Poison Information Centre
• Not effective for the treatment of stings by other scorpion genera

Scorpion venom antiserum contains venom-specific F(ab’) fragments of immunoglobulin G (IgG) which bind and neutralize venom toxins, thereby assisting in the removal of toxins from the target tissue and eliminate it from the body.

Injection 5ml

• SAIMR Scorpion Venom Antiserum (SAVP)