Common Specific Antidotes
Toxin | Antidote |
|---|---|
Acetaminophen | N-Acetylcysteine |
Anticholinergic drugs | Physostigmine* |
Anticoagulants, oral factor Xa inhibitors (apixaban, edoxaban, rivaroxaban) | Coagulation factor Xa [recombinant], inactivated Andexanet alfa |
Antifreeze (ethylene glycol type) | Fomepizole Ethanol |
Benzodiazepines (such as diazepam and lorazepam) | Flumazenil* |
Beta-blockers | Glucagon IV lipid emulsion |
Lactrodectus antivenom | |
Botulism | Botulinum antitoxin |
Calcium channel blockers | Calcium IV insulin in high doses with IV glucose IV lipid emulsion |
Cyanide | Hydroxocobalamin Cyanide antidote kit (Nithiodote®, includes amyl nitrate, sodium nitrite and sodium thiosulfate) |
Dabigatran | Idarucizumab |
Digitalis, including drugs (digoxin) and plants (oleander, foxglove) | Digoxin-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 |
Heparin | Protamine |
Insecticides† (many brands, which may contain carbamates and organophosphates)—ingredients should be checked) | Atropine Pralidoxime |
Iron | Deferoxamine |
Isoniazid | Pyridoxine (vitamin B6) |
Methanol (wood alcohol) | Fomepizole Ethanol |
Methemoglobin‡-forming agents (such as aniline dyes, some local anesthetics, nitrates, nitrites, phenacetin, sulfonamides) | Methylene blue |
Opioids (such as morphine and heroin) | Naloxone |
Scorpion sting (only the Centruroides species) | Centruroides immune fractionated antibodies |
Snakebites§ (rattlesnakes and copperheads in the United States) | Rattlesnake (Crotalinae) antivenom |
Sulfonylurea | Octreotide |
Thallium | Prussian blue |
Tricyclic antidepressants | Sodium bicarbonate |
Valproic acid | L-Carnitine¶ |
Warfarin | 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. | |