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# Polyvalent coral snake antivenom (Micrurus)

Antivenom from Colombia's INS against the neurotoxic venom of coral snakes (Micrurus), which can paralyse the breathing muscles.

Updated 2026-11-01

- Class: [Antivenoms](https://durgical.com/en/pharmacology/classes/antivenoms/)
- Target: Neurotoxins of Micrurus venom
- ATC code: J06AA03
- WHO Model List of Essential Medicines

Also called: Anti-coral antivenom, Anti-Micrurus antivenom, Anti-elapid antivenom

## Mechanism of action

It contains specific immunoglobulins against the venoms of Colombian coral snakes (Micrurus dumerilii, M. mipartitus, M. isozonus and M. surinamensis). Elapid venoms carry small neurotoxins (α-neurotoxins) that occupy the acetylcholine site on the muscle nicotinic receptor and reach their targets quickly. The antivenom neutralises toxin still circulating but does not detach toxin already bound, so it is given early.

- Coral snake neurotoxins quickly reach the neuromuscular junction
- Antibodies neutralise toxin still circulating
- Progression of paralysis is halted
- Bound toxin is not detached: ventilatory support may be needed

## Pharmacokinetics

**Distribution**
Intravenous; races the rapid distribution of small neurotoxins into tissues

## Indications

- Coral snake (Micrurus) bite with suspected envenoming, even before paralysis appears

## Adverse effects

### Common

- Urticaria, itching and fever during the infusion

### Serious (rare, important)

- Anaphylaxis within the first hours
- Serum sickness days to weeks later

## Contraindications

- No absolute contraindication in envenoming that needs it; anaphylaxis treatment is prepared

## Key interactions

**Polyvalent snake antivenom (Bothrops and Crotalus)**
Does not replace it: each antivenom neutralises only the venoms of its genus

## What is monitored

- Signs of progressive muscle weakness: eyelids, swallowing, speech and breathing
- Respiratory function and oxygen saturation
- Signs of anaphylaxis during the infusion

## Administration and safety

- Intravenous only, under continuous medical supervision
- Store refrigerated (2–8 °C)
- Have airway and ventilation support ready as well as anaphylaxis treatment

## Nursing care

- Check eyelids, voice, swallowing and breathing pattern often
- Have airway equipment ready
- Watch for reactions during the infusion
- Record the batch and notify the case

## Pregnancy and breastfeeding

Coral snake envenoming endangers mother and fetus; pregnancy does not prevent antivenom when it is indicated.

## Memory aid

Coral snake = "quiet and paralysing": little local reaction, but paralysis advances without warning; antivenom goes in before breathing fails.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is coral snake antivenom given before paralysis appears?

The small neurotoxins quickly reach the neuromuscular junction and, once bound, the antivenom cannot detach them.

## Does the polyvalent snake antivenom work for a coral snake bite?

No: it neutralises Bothrops and Crotalus venoms; Micrurus needs the coral snake antivenom.

## Which receptor do elapid α-neurotoxins, such as coral snake toxins, act on?

The muscle nicotinic receptor at the neuromuscular junction: they occupy the acetylcholine site and block contraction.

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## Related drugs

- [Polyvalent snake antivenom (Bothrops and Crotalus)](https://durgical.com/en/pharmacology/polyvalent-snake-antivenom/)

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Venta de Antivenenos](https://www.ins.gov.co/Direcciones/Produccion/Paginas/Suero-antiofidico-polivalente.aspx) (Instituto Nacional de Salud (Colombia), 2026); [Snakebite envenoming](https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming) (World Health Organization, 2026); [Guidelines for the production, control and regulation of snake antivenom immunoglobulins, Annex 5, TRS No 1004](https://www.who.int/publications/m/item/snake-antivenom-immunoglobulins-annex-5-trs-no-1004) (World Health Organization, 2017); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 10 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/polyvalent-coral-snake-antivenom/