How Pralidoxime Chloride Is Supplied – Description, Precautions & Adverse Reactions

It is supplied in aqueous solution which is prefilled in the auto-injector for the military use as well as by qualified civilian emergency responders. These auto-injectors are supplied via the Directorate of Medical Material or other analogous state, local or federal agency.

When its activated, every auto-injector dispenses 600 mg of pralidoxime in 2 mg of sterile solution that contains 11.26 mg of glycine in water and 20 mg of benzyl alcohol, the pH is being adjusted with hydrochloric acid, and the product becomes pyrogen free.



This injection provides a sterile solution of Pralidoxime chloride for intramuscular injection. Each injection provides a dose of the 2-PAM in a self contained unit designed particularly for automatic self or buddy administration by the military personnel.

After the auto-injector is being activated, the empty container should be properly disposed. You cannot refill it nor can you retract the needle.

When we activate auto-injector, each of them dispenses 600 mg of the pralidoxime in 2 ml of a sterile solution that contains 20 mg of benzyl alcohol and 11.26 mg of glycine for injection.


In most cases, pralidoxime has been tolerated very well, but it must be kept in mind that the desperate condition of organophosphate-poisoned victim will mask small symptoms and signs as they’ve been noted in normal subjects.

Due to pralidoxime chloride is excreted in the urine, a reduction in a renal function will result in increased blood levels of the drug. Therefore, appropriate steps must be taken to make sure that personnel supplied with auto-injectors recognize their indications and use with the review of symptoms of poisoning and the operation of the auto-injector.

How To Use It

  • Remove gray safety cap.

  • Put black end oppose to outer thigh and push until the injector functions.

  • Hold tightly in place for ten seconds then remove it. And, massage the area of injection.

  • Dispose properly. Push the injected needle via pocket flap and bend it into a hook.

Adverse Reactions:

40-60 minutes after the injection, light to average pain may be experienced at the place of injection.

The Pralidoxime Chloride may cause blured vision and impaired headache, dizziness, nausea, drowsiness, increase in systolic and diastolic blood pressure, muscular weakness and hyperventilation when it’s been given to normal volunteers who haven’t been exposed to anticholinesterase poisons. While in the patients, it’s very tough to differentiate the toxic effects occurred by the organophosphate compounds or the atropine of the drug.

Elevations in SGPT or/and SGOT enzyme levels are being observed in in 1to 6 average volunteers whom given 1200 mg of 2-pyridine aldoxime methyl chloride, and in 4-6 volunteers given 1800 mg of intramuscularly. Levels came back to normal in two weeks.

When pralidoxime and atropine are combined, the signs of atropinisation may produce earlier than when the atropine used alone. It’s true especially when the total dose of atropine is large and the administration of pralidoxime has been postponded. Maniac and excitement behaviour followed immediately in recovery of consciousness which have been reported in many cases.

However, similar behaviour has also been occurred in organophosphate poisoning cases which were not treated with plalidoxime.

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