Indications: adjunct to atropine in the treatment of poisoning by organ phosphorus insecticide or nerve gases (e.g. tabun, sarin, soman)

Cautions: myasthenia gravis

Contra-indication: poisoning with carbamates or with organ phosphorus compounds without anticholinesterase activity.

Renal impairment : use with caution

Side Effects: drowsiness, dizziness, disturbances of vision, nausea, tachycardia, headache, hyperventilation, and muscular weakness.

Dose: By intravenous infusion: adult and child: initially 30 mg/kg over 20 minutes, followed by 8 mg/kg/hour; usual max. 12 g in 24 hours.

Note: The loading dose may be administered by intravenous injection (diluted to a concentration of 50 mg/ml with water for injections) over at least 5 minutes if pulmonary oedema is present or if it is not practical to administer an intravenous infusion; pralidoxime chloride doses in BNF may differ from those in product literature.