Common Specific Antidotes
Toxin | Antidote |
|---|---|
AcetaminophenAcetaminophen | N-Acetylcysteine-Acetylcysteine |
Anticholinergic drugs | Physostigmine*Physostigmine* |
Anticoagulants, oral factor Xa inhibitors (apixaban, edoxaban, rivaroxaban)Anticoagulants, oral factor Xa inhibitors (apixaban, edoxaban, rivaroxaban) | Coagulation factor Xa [recombinant], inactivated Andexanet alfa |
Antifreeze (ethylene glycol type) | FomepizoleFomepizole Ethanol |
Benzodiazepines (such as diazepam and lorazepam)Benzodiazepines (such as diazepam and lorazepam) | Flumazenil*Flumazenil* |
Beta-blockers | GlucagonGlucagon IV lipid emulsion |
Lactrodectus antivenom | |
Botulism | Botulinum antitoxin |
Calcium channel blockers | Calcium IV insulin in high doses with IV glucoseIV insulin in high doses with IV glucose IV lipid emulsion |
Cyanide | HydroxocobalaminHydroxocobalamin Cyanide antidote kit (Nithiodote®, includes amyl nitrate, sodium nitrite and sodium thiosulfate)Cyanide antidote kit (Nithiodote®, includes amyl nitrate, sodium nitrite and sodium thiosulfate) |
DabigatranDabigatran | IdarucizumabIdarucizumab |
Digitalis, including drugs (digoxin) and plants (oleander, foxglove)Digitalis, including drugs (digoxin) and plants (oleander, foxglove) | Digoxin-specific antibodiesDigoxin-specific antibodies |
Heavy metals (such as arsenic, cadmium, lead, mercury, and zinc) | Drugs that remove heavy metals from the body (chelating drugs), such as dimercaprol, edetate calcium disodium, penicillamine, and succimer Drugs that remove heavy metals from the body (chelating drugs), such as dimercaprol, edetate calcium disodium, penicillamine, and succimer |
HeparinHeparin | ProtamineProtamine |
Insecticides† (many brands, which may contain carbamates and organophosphates)—ingredients should be checked) | AtropineAtropine Pralidoxime |
Iron | DeferoxamineDeferoxamine |
IsoniazidIsoniazid | Pyridoxine (vitamin B6)Pyridoxine (vitamin B6) |
Methanol (wood alcohol) | FomepizoleFomepizole Ethanol |
Methemoglobin‡-forming agents (such as aniline dyes, some local anesthetics, nitrates, nitrites, phenacetin, sulfonamides) | Methylene blueMethylene blue |
Opioids (such as morphine and heroin)(such as morphine and heroin) | NaloxoneNaloxone |
Scorpion sting (only the Centruroides species) | Centruroides immune fractionated antibodies |
Snakebites§ (rattlesnakes and copperheads in the United States) | Rattlesnake (Crotalinae) antivenom |
Sulfonylurea | OctreotideOctreotide |
Thallium | Prussian blue |
Tricyclic antidepressants | Sodium bicarbonateSodium bicarbonate |
Valproic acidValproic acid | L-Carnitine¶ |
WarfarinWarfarin | Vitamin K Fresh frozen plasma (FFP) Prothrombin complex concentrate (PCC) |
* Use is controversial. | |
† The antidotes cited are for carbamate and organophosphate insecticides only. | |
‡ Methemoglobin is an abnormal form of hemoglobin that is produced by certain poisons. Unlike normal hemoglobin, methemoglobin does not carry oxygen so the body's tissues do not get enough oxygen. | |
§ Antivenom is specific to the species of snake. There are many antivenoms, but rattlesnakes and copperheads cause most poisonous snakebites in the United States. | |
¶ There is limited evidence that L-carnitine is a good general antidote for acute valproic acid overdose. However, L-carnitine is likely to be safe, so it is a reasonable treatment in people who have a decreased level of consciousness. ¶ There is limited evidence that L-carnitine is a good general antidote for acute valproic acid overdose. However, L-carnitine is likely to be safe, so it is a reasonable treatment in people who have a decreased level of consciousness. | |