Toxins 2016, 8(8), 244; https://doi.org/10.3390/toxins8080244
A Single Dose of ViperfavTM May Be Inadequate for Vipera ammodytes Snake Bite: A Case Report and Pharmacokinetic Evaluation
Tihana Kurtović 1,†
, Miran Brvar 2,3,†,*
, Damjan Grenc 2, Maja Lang Balija 1, Igor Križaj 4,5 and Beata Halassy 1
, Miran Brvar 2,3,†,*
, Damjan Grenc 2, Maja Lang Balija 1, Igor Križaj 4,5 and Beata Halassy 11
Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia
2
Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
3
Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
4
Department of Molecular and Biomedical Sciences, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia
5
Faculty of Chemistry and Chemical Technology, University of Ljubljana, Večna pot 113, 1000 Ljubljana, Slovenia
†
These authors contribute equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Wayne Hodgson
Received: 30 June 2016 / Accepted: 11 August 2016 / Published: 19 August 2016
(This article belongs to the Section Animal Venoms)
Abstract
ViperfavTM is a commercial F(ab’)2 antivenom prepared against European vipers venom. It is safe and effective for treating envenomation caused by Vipera aspis and Vipera berus. Therapeutic efficacy for treating Vipera ammodytes ammodytes (V. a. ammodytes) envenoming has not been yet described, although protective efficacy has been demonstrated in preclinical studies. We report on a 32-year-old man bitten by V. a. ammodytes who was treated with Viperfav™. Viperfav™ promptly reduced local extension and improved systemic pathological signs, but 24 h after the incident a recurrence of thrombocytopenia occurred despite a favorable pharmacokinetic profile with systemic clearance (1.64 (mL·h−1)·kg−1) and elimination half-life (97 h) among the highest ever reported. The recommended dose of Viperfav™ for V. aspis and V. berus bites may be inadequate for serious V. a. ammodytes envenomations. Following V. a. ammodytes bite, serial blood counts and coagulation profiles should be performed to help guide Viperfav™ treatment, along with supplemental administration as indicated. View Full-TextKeywords:
Vipera ammodytes ammodytes envenomation; Viperfav™ antivenom treatment; F(ab’)2 antivenom pharmacokinetics
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Kurtović, T.; Brvar, M.; Grenc, D.; Lang Balija, M.; Križaj, I.; Halassy, B. A Single Dose of ViperfavTM May Be Inadequate for Vipera ammodytes Snake Bite: A Case Report and Pharmacokinetic Evaluation. Toxins 2016, 8, 244.
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