Pralidoxime Chloride: Uses, Dosage, Side Effects | MedexInfo

Pralidoxime Chloride

Rx Only

Generic NamePralidoxime Chloride

Therapeutic ClassCholinesterase Reactivator / Antidote

Common Dose1–2 g IV initially

Max / 24hAs clinically indicated

PregnancyCategory C

Indications ▼

Organophosphate insecticide poisoning

Nerve agent exposure

Carbamate poisoning (selected cases)

Adjunct to atropine therapy in cholinergic crisis

Mechanism & Pharmacokinetics ▼

Mechanism: Reactivates acetylcholinesterase inhibited by organophosphates by cleaving the phosphate-enzyme bond, restoring neuromuscular transmission and reducing cholinergic toxicity.

Pharmacokinetics: Administered IV or IM; widely distributed in extracellular fluid. Limited penetration into CNS. Eliminated mainly via kidneys. Half-life approximately 1–2 hours.

Dosage & Administration ▼

Patient Category	Recommended Dose	Max / 24h
Adults (Initial)	1–2 g IV over 15–30 minutes	As clinically required
Adults (Maintenance)	500 mg/hour IV infusion or repeat 1 g every 1 hour as needed	As clinically required
Children	20–50 mg/kg IV over 15–30 minutes	As prescribed
IM (Auto-injector)	600 mg IM; may repeat at 15-minute intervals if needed	As directed

Note: Administer as soon as possible after exposure. Always use in combination with atropine and supportive care. Adjust dose in renal impairment.

Side Effects ▼

Common: Headache, dizziness, blurred vision

Occasional: Tachycardia, hypertension, nausea

Rare: Muscle rigidity, respiratory distress, hypersensitivity reactions

Contraindications ▼

Known hypersensitivity to pralidoxime

Use cautiously in renal impairment

Drug Interaction ▼

Atropine: used concomitantly for optimal effect

Morphine or CNS depressants: may worsen respiratory depression

Barbiturates: increased neuromuscular weakness risk

Pregnancy & Lactation ▼

Category C; use if benefits outweigh potential risks

Safety in breastfeeding not well established

Clinical / Research Summary ▼

Essential antidote in organophosphate poisoning management.

Most effective when administered early before enzyme “aging” occurs.

Reduces neuromuscular paralysis and respiratory complications.

Patient Counseling Points ▼

Used only in emergency settings under medical supervision.

Immediate medical care required after suspected poisoning.

Report breathing difficulty or severe weakness promptly.

Storage & Handling ▼

Store at 20–25°C; protect from light

Do not use if solution is discolored

Brand Names (Bangladesh & Global) ▼

Bangladesh:

Pradox® 1000 mg/ml Injection Pralidot® 1000 mg/ml Injection Pralidox® 1000 mg/ml Injection

Global:

Protopam® Pralidoxime Chloride (Generic)

Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider.

Reference Hubs:

• Drug Class: Antidotes • Condition: Organophosphate Poisoning • Clinical Evidence & Trials