Coral snake (micrurus fulvius) immune globulin antivenin (equine)

Identification

Summary

Coral snake (micrurus fulvius) immune globulin antivenin (equine) is a mixture of antibodies used to treat venomous snake bites from Micrurus fulvius (North American Coral Snake).

Generic Name
Coral snake (micrurus fulvius) immune globulin antivenin (equine)
DrugBank Accession Number
DB13883
Background

North American Coral Snake Antivenin (Equine) is a horse-derived antivenin indicated for the treatment of envenomation caused by North American coral snake bites. It is intravenously administered so that the antivenin binds to and neutralizes coral snake venom.

The antivenin is a refined, concentrated, and lyophilized preparation of serum globulins obtained by fractionating blood from healthy horses that have been immunized with eastern coral snake (Micrurus fulvius fulvius) venom Label. Prior to lyophilization, the product contains 0.25% phenol and 0.005% thiomerosal (mercury derivative) Label.

Type
Biotech
Groups
Approved, Experimental
Biologic Classification
Protein Based Therapies
Other protein based therapies
Protein Chemical Formula
Not Available
Protein Average Weight
Not Available
Sequences
Not Available
Synonyms
  • Antivenin (micrurus fulvius)
  • Antivenin,micrurus fulvius
  • Coral snake (micrurus fulvius) antivenin (equine)
  • Coral snake (micrurus fulvius) immune antivenin (equine)
  • Coral snake antivenin
  • Coral Snake Immune Globulin (Horse)
  • North american coral snake (micrurus fulvius) antivenin (equine)
  • North American coral snake antivenin
  • North American Coral Snake Antivenin (Equine)
  • North american coral snake antivenin (micrurus fulvius) (equine)

Pharmacology

Indication

This particular antivenin is indicated only for the treatment of envenomation caused by bites from Eastern coral snakes (Micrurus fulvius fulvius) and Texas coral snakes (Micrurus fulvius tenere) Label,3. The agent will not neutralize the venom of Arizona (Sonoran) coral snakes (Micruroides euryxanthus) or that of South American species Label,3.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

North American Coral Snake Antivenin (Equine) is standardized for potency in mice in terms of its LD50 neutralizing capacity per milliliter as determined by intravenous injection of a graded series of mixtures of North American Coral Snake Antivenin (Equine) with M. f. fulvius venom Label,3. Based on this assay system, the reconstituted contents of each vial (10 mL) will neutralize about 250 mouse LD50 or approximately 2 mg of M. f. fulvius venom Label,3.

Mechanism of action

North American Coral Snake Antivenin (Equine) is a preparation of serum globulins obtained by fractionating blood from healthy horses that have been immunized with eastern coral snake (Micrurus fulvius fulvius) venom Label,3.

When the antivenin is appropriately administered intravenously, it essentially functions like an injection of antibodies that directly bind to and neutralize coral snake venom that has entered the bloodstream due to any kind of coral snake bite Label,3.

Absorption

As the antivenin is essentially an emergency antivenom medication that is administered intravenously in hopes of eliciting an as immediate as possible coral snake venom neutralization in a patient's bloodstream, it is generally assumed that the emergency injection is absorbed entirely.

Volume of distribution

The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins Label,3 obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG antivenoms generally demonstrate a lower volume of distribution in comparison to antivenoms comprised of Fab or F(ab')2 fragments and has been known to potentially exist within the range of 162 +/- 1.9 mL/kg in a rabbit model 1.

Protein binding

Information regarding the protein binding of this antivenin agent is not readily available, although its predominant mechanism of action revolves around binding specifically to Micrurus fulvius fulvius and Micrurus fulvius tenere coral snake venom.

Metabolism

The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins Label,3 obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such IgG components undergo much catabolism at the gut and liver in a mouse model 1. Any such IgG molecules with intact carbohydrate containing Fc portions may also experience carbohydrate-specific uptake mechanisms associated with mononuclear phagocyte activity in the liver and other organs 1. Additionally, although it has been observed that the liver and spleen demonstrate the highest IgG catabolism activity in the rat model on a weight basis, in terms of total catabolism, the peripheral tissues, skin, and muscle play the dominant role, indicating that the catabolism of antibodies may occur all throughout the body system 1.

Route of elimination

The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins Label,3 obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such IgG containing formulations may have the majority of its IgG components eliminated mainly via extrarenal mechanisms 1.

Half-life

The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins Label,3 obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG formulations demonstrate an intermediate distribution half-life ranging from 5.22 +/- 0.98 hours to 5.98 +/- 0.67 hours and an elimination half-life ranging from 42.66 +/- 2.04 hours to 46.4 +/- 4.8 hours in a rabbit model 1.

Clearance

The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins Label,3 obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG formulations demonstrate a rate of clearance ranging anywhere from 0.36 +/- 0.06 mL/h/kg to 5.46 +/ 0.6 mL/h/kg 1.

Adverse Effects
Adverseeffects
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Toxicity

Patients sensitive to antivenin or horse serum may develop anaphylaxis Label. Therefore, it is essential that prior to any antivenin administration a proper skin test be performed, interpreted, and therapy modified if indicated Label. Anaphylaxis seen with antivenins of equine origin may result in an immediate reaction (shock) usually occurring within 30 minutes Label. Signs and symptoms may develop before the needle of administration is even withdrawn from the patient and can include apprehension, flushing, itching, urticaria; edema of the face, tongue, and throat; cough, dyspnea, cyanosis, vomiting, collapse, and possibly even cardiac arrest or death Label.

Constant attendance and observation for untoward response is mandatory whenever horse serum is administered intravenously so that, should such occur, injection may be discontinued and appropriate treatment instituted immediately Label.

Even if it is appropriate for a patient to be administered the antivenin, the most common adverse reactions observed after treatment with the agent has been anaphylaxis and serum sickness, vomiting, and abdominal pain Label.

LD50 values are available for animal models such as the rat, in which the oral LD50 is documented to be 317 mg/kg and the dermal LD50 as 525 mg/kg MSDS.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Not Available
Food Interactions
No interactions found.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Antivenin (micrurus Fulvius)Injection, powder, for solution1 g/10mLIntravenousWyeth Pharmaceuticals Company1967-06-012001-08-31US flag
North American Coral Snake Antivenin (Equine)Injection, powder, for solution250 [arb'U]/10mLIntravenousWyeth Pharmaceuticals Llc, a Subsidiary of Pfizer Inc.2016-10-12Not applicableUS flag

Categories

Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
Y605XBM2GL
CAS number
Not Available

References

General References
  1. Gutierrez JM, Leon G, Lomonte B: Pharmacokinetic-pharmacodynamic relationships of immunoglobulin therapy for envenomation. Clin Pharmacokinet. 2003;42(8):721-41. doi: 10.2165/00003088-200342080-00002. [Article]
  2. Leon G, Stiles B, Alape A, Rojas G, Gutierrez JM: Comparative study on the ability of IgG and F(ab')2 antivenoms to neutralize lethal and myotoxic effects induced by Micrurus nigrocinctus (coral snake) venom. Am J Trop Med Hyg. 1999 Aug;61(2):266-71. [Article]
  3. Dailymed: North American Coral Snake Antivenin (Equine) - coral snake (microbus fulvous) immune globulin antivenin (equine) injection, powder, for solution Label [Link]
PubChem Substance
347911452
RxNav
979384
FDA label
Download (69.9 KB)
MSDS
Download (42.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, powder, for solutionIntravenous1 g/10mL
Injection, powder, for solutionIntravenous250 [arb'U]/10mL
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
Not Available

Drug created at September 07, 2017 19:03 / Updated at June 19, 2021 00:27