Antivenom Safety

CroFab has an excellent safety profile.

Per Dr. Greene:

Although every medication has the potential to cause an adverse reaction, CroFab has an excellent safety profile. In a large meta-analysis, the incidence of acute adverse reactions to CroFab was estimated at 8% (Schaeffer et al.). A study using data from the North American Snakebite Registry found the incidence of acute adverse reactions to be ~ 2.3% (Kleinschmidt et al.). Authors from the Arizona Poison and Drug Information Center calculated the incidence of acute adverse reactions to be approximately 1.4%, and nobody in this relatively large study required antivenom discontinuation (Khobrani et al.).

There are certain conditions (e.g. latex allergy) that may predispose to an adverse reaction, but there’s no absolute contraindication to antivenom. If somebody’s envenomation warrants treatment, you treat with antivenom. You can always run an epinephrine infusion simultaneously, or at least have it readily available.

The cited articles can be found in our files section, and you can see the abstracts here:

Schaeffer: Incidence of immediate hypersensitivity reaction and serum sickness following administration of Crotalidae polyvalent immune Fab antivenom: a meta-analysis

Kleinschmidt: Acute adverse events associated with the administration of Crotalidae polyvalent immune Fab antivenom within the North American Snakebite Registry

Khobrani: Incidence of allergic reactions to Crotalidae polyvalent immune Fab