Pralidoxime
Given with atropine in organophosphate poisoning: 30 mg/kg IV over 20 minutes, then 8 mg/kg/hour. Atropine is the life-saving drug.
On this page
Dose
30 mg/kg IV over 20 minutes, then 8 mg/kg/hour infusion until recovery (WHO-endorsed regimen). Child: 25–50 mg/kg then infusion.
Points
- Atropine first and generously: double the dose every 5 minutes until the chest is clear, HR over 80 and systolic BP over 80.
- Oxime benefit is uncertain and less with some pesticides; give early if available.
- Decontaminate: remove clothes, wash skin; staff wear gloves.
Frequently asked questions
Is pralidoxime essential in organophosphate poisoning?
Atropine and supportive care save lives; pralidoxime is an add-on with debated benefit.
Used in these guides
Sources
Doses on this page are typical doses from the sources above. Always confirm with a current drug reference, the product leaflet and your hospital protocol, especially in children, pregnancy and kidney or liver disease.
For FCPS Part 1
Revising for FCPS Part 1? Pralidoxime is covered in our textbook chapter Cholinergic drugs, with practice MCQs.