March 21, 2017

Pralidoxime injection

What is pralidoxime injection?

PRALIDOXIME (Protopam®) treats poisoning by some insecticides (called organophosphates) and nerve agents, and overdoses of some medicines that treat myasthenia gravis. Generic pralidoxime injection is available. Emergency kits for injection are also available.

What should my health care professional know before I receive pralidoxime?

They need to know if you have any of these conditions:

  • kidney disease

  • myasthenia gravis

  • an unusual or allergic reaction to pralidoxime, other medicines, foods, dyes, o preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

Pralidoxime is for injection into a muscle, under the skin, or into a vein. It is given by a health-care professional in a hospital or clinic setting. Pralidoxime is not for self-medication, except in emergency situations when it is possible that workers may be exposed to nerve agents or organophosphate insecticides. Injection kits are available for self-injection in case of emergency. Learn how and when to use the autoinjector before an emergency arises. If organophosphate poisoning occurs, atropine and pralidoxime are given as soon as possible. An atropine injection is given first and after the effects become apparent pralidoxime is given. Repeat the injections of atropine and pralidoxime after 15 minutes if symptoms continue, and again after an additional 15 minutes if symptoms persist. If symptoms of nerve agent exposure continue after the third set of injections, obtain medical help.

What if I miss a dose?

This does not apply.

What drug(s) may interact with pralidoxime?

  • atropine

  • barbiturate medicines for inducing sleep or treating seizures (convulsions)

  • medicines that improve muscle strength or tone for conditions like myasthenia gravis

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking pralidoxime?

Pralidoxime is not intended for long-term use. Contact your prescriber or health care professional immediately after an organophosphate or nerve agent poisoning occurs for instructions regarding treatment.

Remove contaminated clothing and wash the poison from the skin and hair.

What side effects may I notice from receiving pralidoxime?

Side effects may be difficult to distinguish from those caused by the poison.

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • hyperventilation (over breathing)

  • muscle rigidity

  • rapid heartbeat

  • spasm of the larynx (voice box)

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • blurred or double vision

  • dizziness, drowsiness

  • excitement, agitation, or manic behavior

  • headache

  • muscle weakness

  • nausea, vomiting

  • skin rash

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature, approximately 25 degrees C (77 degrees F). Throw away any unused medicine after the expiration date.


March 21, 2017


U.S. FDA-approved Package Insert