l INDICATIONS AND DOSE

Adjunct to atropine in the treatment of poisoning by organophosphorus insecticide or nerve agent

 BY INTRAVENOUS INFUSION

 Child: Initially 30 mg/kg, to be given over 20 minutes, followed by 8 mg/kg/hour; maximum 12 g per day  Adult: Initially 30 mg/kg, to be given over 20 minutes, followed by 8 mg/kg/hour; maximum 12 g per day 

l UNLICENSED USE

Pralidoxime chloride doses may differ from those in product literature.  In children Licensed for use in children (age range not specified by manufacturer).

l CONTRA-INDICATIONS

Poisoning with carbamates . poisoning with organophosphorus compounds without anticholinesterase activity

l CAUTIONS

Myasthenia gravis

l SIDE-EFFECTS

Dizziness . drowsiness . headache . hyperventilation . muscle weakness . nausea .tachycardia . visual impairment

l RENAL IMPAIRMENT

Use with caution.

l DIRECTIONS FOR ADMINISTRATION

The loading dose may be administered by intravenous injection (diluted to a concentration of 50 mg/mL with water for injections) over at least 5 minutes if pulmonary oedema is present or if it is not practical to administer an intravenous infusion.  In children For intravenous infusion, reconstitute each vial with 20 mL Water for Injections, then dilute to a concentration of 10–20 mg/mL with Sodium Chloride 0.9%.

l PRESCRIBING AND DISPENSING INFORMATION

Available from designated centres for organophosphorus insecticide poisoning or from the National Blood Service (or Welsh Ambulance Services for Mid West and South East Wales)— see TOXBASE for list of designated centres).

l EXCEPTIONS TO LEGAL CATEGORY

Prescription only medicine restriction does not apply where administration is for saving life in emergency