Cnidaria Envenomation Medication

Updated: Mar 16, 2022
  • Author: Spencer Greene, MD, MS, FACEP, FACMT, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
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Medication Summary

Box jellyfish antivenom, manufactured by Commonwealth Serum Laboratory in Melbourne, Australia, is ovine-derived concentrated immunoglobulins. Each ampule contains sufficient activity to neutralize 20,000 intravenous mouse doses (amount of toxin lethal in a 20-g mouse) of C. fleckeri venom. Chironex antivenom cross-reacts with Chiropsalmus species venom to prevent neurotoxic and myotoxic effects. However, it has not prevented cardiovascular effects in vivo. Antivenom is indicated in the following situations: cardiopulmonary arrest, hypotension, dysrhythmia, coma, or difficulty with breathing, swallowing, or speaking. It is also recommended in cases of severe pain that are refractory to more conservative treatment. Its use may be considered when the possibility of severe scarring is high.