Antidote Master List

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Updated November 6, 2017

There are multiple factors that affect a patient’s presentation and treatment options. The information herein is intended for educational purposes and should not be used to supersede clinical judgement or toxicologic consultation.

Anti-VeninsDosage/AdministrationPotential IndicationsQuantity to Treat One 70 kg Patient for 24 Hours*
Anascorp® -
scorpion centruroides species
3 vials IVsevere envenomation3 vials IV
Black Widow Spider Antivenin (Lactrodectus mactans) (equine)1 vial in 10-50 mL 0.9% sodium chloride IV over 15 minutes
OR
1 vial IM in anterolateral thigh
black widow spider envenomation1 vial
Coral Snake Antivenin (Micrurus fulvius) (equine) Contact poison control center: 1-800-222-1222Eastern or Texas coral snake envenomation10 vials
Crotalidae Polyvalent Immune Fab (ovine) (CroFab®)Contact poison control center: 1-800-222-1222pit viper envenomation20 vials

AntidoteDosage/AdministrationPotential IndicationsQuantity to Treat One 70 kg Patient for 24 Hours*
N-acetylcysteine Mucomyst® (PO)Multiple protocols exist.
Contact poison control center: 1-800-222-1222
acetaminophen, cyclopeptide containing mushrooms (e.g. Amanita phalloides), chloroform, carbon tetrachloride, pennyroyal oil7 vials
Acetadote® (IV)Multiple protocols exist.
Contact poison control center: 1-800-222-1222
6 vials
Cetylev® (PO)Multiple protocols exist.
Contact poison control center: 1-800-222-1222
40 g
activated charcoalAdult: 50 g PO
Pediatric: 1 g/kg PO
all oral ingestions besides hydrocarbons, alcohols, metals, corrosives, and foreign objects3 bottles (50 g each)
atropine sulfateAdult: 1-3 mg IV bolus, repeat 1-5 mg IV Q 2-20 minutes
Pediatric: 0.05-0.1 mg/kg/dose IV Q 5-15 minutes
organophosphate, carbamate insecticides, muscarine containing mushrooms1 gram
benztropine (Cogentin®)1 mg IV or IM (can repeat up to 4 mg initially)
MAINTENANCE: 1-4 mg IV once or twice/daily (max 6 mg/day)
acute dystonic reactions3 ampules (2 mg/2 mL each)
bromocriptine mesylate (Parlodel®)2.5-10 mg PO Q 8-12 hours (max 45 mg/day)neuroleptic malignant syndrome45 mg
calcium disodium edetate (EDTA)30-75 mg/kg/day IV divided Q 8-12 hourscadmium, chromium, cobalt, copper, iridium, lead, manganese, mercury, nickel, plutonium, ruthenium, yttrium, zinc, zirconium4 g
calcium gluconate 10%Contact poison control center: 1-800-222-1222calcium channel blockers, hydrofluoric acid10 – 20 vials (1 g each)
Cyanide Antidote Kit (Nithiodote®) (also see hydroxocobalamin)sodium nitriteContact poison control center: 1-800-222-1222cyanide and hydrogen sulfide toxicity2 kits
sodium thiosulfate
cyproheptadine (Periactin®)Adult: 12 mg PO or NG initially then 8 mg Q 6 hours (32 mg max/day)
Pediatric: 0.25 mg/kg/day in 4 divided doses
serotonin syndrome32 mg
dantrolene sodium (Dantrium®)(Ryanodex®)1-2.5 mg/kg IV (repeat until symptoms subside)(max 10 mg/kg)neuroleptic malignant syndromeDantrium® (20 mg/vial): 35 vials Ryanodex® (250mg/vial): 3 vials
deferoxamine mesylate (Desferal®)15 mg/kg/hour IViron, aluminum, manganese, neptunium, plutonium26 g
digoxin immune Fab (ovine) (Digifab®)Adult:
-Empiric dosing: 20 vials
digoxin, cardiac glycosides (oleander, foxglove, red squill, bufo toad)20 vials
Pediatric
-Empiric dosing: 10 vials
◦ If serum level available:
[serum digoxin] x weight (kg)/100 kg = # of vials
◦ If ingested amount known
each vial is expected to bind 500 mcg of ingested digoxin
dimercaptosuccinic acid (DMSA) (succimer, Chemet®)10 mg/kg PO TID for 5 days then 10 mg/kg PO BID for 14 dayslead20 capsules (100 mg each)
dimercaprol (BAL®)3-5 mg/kg IM Q 4-6 hours (contraindication peanut allergy)lead, mercury, arsenic, gold, antimony, bismuth, lead, nickel, polonium1200 mg (7 ampules)
ethyl alcohol 95% (ethanol)Contact poison control center: 1-800-222-1222methanol, ethylene glycol100 mL of 95% ethanol
flumazenil (Romazicon®)Contact poison control center: 1-800-222-1222benzodiazepines, zolpidem, eszopiclone5 mg
folic acid50 mg IV Q 4 hoursmethanol300 mg (6 vials)
fomepizole (Antizol®)LOAD: 15 mg/kg IV over 30 minutes
MAINTENANCE: 10 mg/kg IV Q 12 hours for 4 doses then 15 mg/kg IV Q 12 hours thereafter
methanol, ethylene glycol3000 mg (2 vials)
glucagon (Glucagen®)Adult:
LOAD: 5-10 mg IV
MAINTENANCE: 2.5-5 mg/hour IV
beta blockers, calcium channel blockers100 mg (100 vials)
Pediatric:
LOAD: 50-150 mcg/kg IV
MAINTENANCE: 50-150 mcg/kg/hour IV
glucarpidase (Voraxaze®)50 units/kg IVmethotrexate3500 units (4 vials)
hydroxocobalamin (Cyanokit®)5 g IV (can repeat)cyanide, hydrogen sulfide10 g (2 vials)
idarucizumab (Praxbind®)5 g IV given as two consecutive 2.5 g IV bolusesdabigatran5 g (2 vials)
insulin (regular)LOAD: 1 unit/kg IV boluscalcium channel blocker, beta blocker20 vials (1000 units/10 mL vials)
INFUSION: 1-10 mg/kg/hour continuous IV infusion
lipid emulsion 20% (Intralipid®)Contact poison control center: 1-800-222-1222severe intoxication with lipophilic drug (cyclic antidepressants, bupropion, calcium channel blockers, beta blockers)2 bags (500 mL each)
Contact poison control center: 1-800-222-1222local anesthetic systemic toxicity
leucovorin (folinic acid)50 mg IV oncemethanol1 vial (50 mg each)
levocarnitine (Carnitor®)LOAD: 100 mg/kg IV (max 6000 mg given over 30 minutes)
MAINTENANCE: 50 mg/kg (max 3000 mg) IV Q 8 hours
valproic acid-induced hyperammonemic encephalopathy15 g
mannitol 20%1 g/kg IV over 30 minutesciguatera70 g
methylene blue 0.5%1-2 mg/kg IV over 5 minutes, may repeat in 30-60 minutes (max 7 mg/kg/day)methemoglobinemia10 ampules (5 mg/mL, 10 mL each)
naloxonenaloxone intravenous0.4-10 mg IV Q 15-45 minutes or by continuous infusionopioids, clonidine, tizanidine30 mg
Narcan® nasal atomizer2-4 mg IN, alternate nostrils Q 1-5 minutes
Evzio® intramuscular0.4-2 mg IM
octreotide (Sandostatin®)Adult: 50 mcg IVsulfonylureas4 vials (50 mcg each)
Pediatric: 1-10 mcg/kg IV
D-penicillamine (Cuprimine®)Adult: 1000-1500 mg/kg/day PO in 3-4 divided doseslead, mercury, arsenic, copper, antimony, bismuth, gallium, gold, palladium, polonium1500 mg
Pediatric: 20-30 mg/kg/day PO in 3-4 divided doses
pentetate calcium trisodium (calcium-DTPA)1000 mg IV or inhaledinternal contamination with plutonium, americium, or curium1000 mg (200 mg/mL – 5 mL vial)
pentetate zinc trisodium (zinc-DTPA)1000 mg IV or inhaledinternal contamination with plutonium, americium, or curium1000 mg (200 mg/mL – 5 mL vial)
physostigmine (Antilirium®)Adult: 1-2 mg slow IV pushanticholinergic toxicity15 ampules
Pediatric: 0.02 mg/kg slow IV push
polyethylene glycol electrolyte lavage solution (Golytely®, Colyte®)Adult: 500 mL/hour titrated up by 500 mL/hour Q 30 minutes to a goal rate of 2 L/hour PO or NGwhole bowel irrigation4 gallons
Pediatric: Initiate NG infusion at 5-10 mL/kg/hour and titrate up to 25 mL/kg/hour
potassium iodideAdult: 130 mgiodine 1311 tablet (130 mg)
Pediatric (3 years - 18 years): 65 mg2 mL (65 mg/mL)
Pediatric (1 month - 3 years): 32 mg
Pediatric (birth - 1 month): 16 mg
pralidoxime (2-PAM®, Protopam®)Adult:
LOAD: 30 mg/kg (max 2 g) IV over 30 minutes
MAINTENANCE: 8-10 mg/kg/hour (max 500 mg/hour)
organophosphates12 vials
Pediatric:
LOAD: 20-40 mg/kg (max 2 g) IV over 30 minutes
MAINTENANCE: 10-20 mg/kg/hr (max 500 mg/hour)
protamine sulfate1-1.5 mg to reverse each 100 mL heparinheparin4 ampules or 1 vial
prothrombin complex concentrate, human (PCC) (Kcentra®, FEIBA®, etc.)Contact poison control center:
1-800-222-1222
warfarins, brodifacoum, hydroxycoumarins, other anticoagulants (apixaban, dabigatran, rivaroxaban, edoxaban, etc.)max 5000 units of Factor IX
prussian blue (Radiogardase®)Adult: 3 g PO TIDthallium and cesium 1379 g (18 – 500 mg capsules)
Pediatric: 1 g PO TIDNOTE: patients normally require at least 30 days of treatment
pyridoxine (vitamin B6)1 g for every 1 g isoniazid ingested
OR
70 mg/kg IV (max 5000 mg)
isoniazid, hydrazines, Gyromitra mushrooms50 vials (100 mg/mL)
thiamine50-100 mg IVWernicke-Korsakoff Syndrome, ethylene glycol15 vials (1.5 g)
1 vial (100 mg)
uridine triacetate (Vistogard®)10 g (1 packet) PO Q 6 hours for 20 doses5-fluorouracil or capecitabine4 packets (10 g)
vitamin K (Aqua Mephyton®, Phytonadione®)INR ≥ 10 with no bleeding: 2.5-5 mg POwarfarins, brodifacoum, hydroxycoumarins1 ampule (10 mg)
Serious bleeding despite INR:
5-10 mg/dose IV slow infusion

*This quantity is not intended to represent a recommended par level nor is it a required amount to have on hand at all facilities.