Protopam Side Effects Center

Last updated on RxList: 6/29/2022
Protopam Side Effects Center

What Is Protopam?

Protopam (pralidoxime chloride) is a cholinesterase reactivator that reverses muscle weakness or paralysis caused by a poison or certain drug overdose used as an antidote to treat poisoning by a pesticide or by a drug used to treat a muscle disorder. Protopam is not effective as an antidote for all types of pesticide poisonings.

What Are Side Effects of Protopam?

Common side effects of Protopam include:

  • pain where the medicine was injected,
  • blurred vision,
  • dizziness,
  • drowsiness,
  • headache, or
  • nausea

Seek medical care or call 911 at once if you have the following serious side effects:

  • Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out;
  • Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors.

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

Dosage for Protopam

Protopam is given as an intravenous infusion under physician supervision. The initial dose is 1000 to 2000 mg, preferably as an infusion in 100 mL of normal saline, over a 15- to 30-minute period.

What Drugs, Substances, or Supplements Interact with Protopam?

Protopam may interact with:

  • atropine,
  • reserpine,
  • chlorpromazine,
  • fluphenazine,
  • mesoridazine,
  • perphenazine,
  • prochlorperazine,
  • thioridazine, or
  • trifluperazine
  • Tell your doctor all medications and supplements you use.

    Protopam During Pregnancy or Breastfeeding

    During pregnancy, Protopam should be used only if prescribed. It may be harmful to a fetus. It is unknown if this drug passes into breast milk or if it could harm a nursing baby. Consult your doctor before breastfeeding.

    Additional Information

    Our Protopam (pralidoxime chloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

    This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


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    Protopam Consumer Information

    Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

    Some of the side effects of pralidoxime may be similar to the symptoms of poisoning. Your caregivers will watch you closely to determine whether your body is responding well to the medication, or if you are having any serious side effects.

    Tell your caregivers right away if you have:

    • fast or pounding heartbeats;
    • chest tightness, shortness of breath;
    • anxiety, dizziness, or nervousness;
    • numbness or tingling;
    • painful or difficult urination;
    • little or no urination;
    • vision problems; or
    • muscular weakness.

    Side effects may be more likely in older adults.

    Common side effects may include:

    • pain for up to an hour after injection into a muscle;
    • trouble breathing;
    • vision changes;
    • nausea;
    • fast heartbeats, increased blood pressure;
    • headache, dizziness, drowsiness; or
    • muscle weakness.

    This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


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    Protopam Professional Information


    Forty to 60 minutes after intramuscular injection, mild to moderate pain may be experienced at the site of injection.

    Pralidoxime chloride may cause blurred vision, diplopia and impaired accommodation, dizziness, headache, drowsiness, nausea, tachycardia, increased systolic and diastolic blood pressure, hyperventilation, and muscular weakness when given parenterally to normal volunteers who have not been exposed to anticholinesterase poisons. In patients, it is very difficult to differentiate the toxic effects produced by atropine or the organophosphate compounds from those of the drug.

    Elevations in SGOT and/or SGPT enzyme levels were observed in 1 of 6 normal volunteers given 1200 mg of pralidoxime chloride intramuscularly, and in 4 of 6 volunteers given 1800 mg intramuscularly. Levels returned to normal in about 2 weeks. Transient elevations in creatine phosphokinase were observed in all normal volunteers given the drug.

    When atropine and pralidoxime chloride are used together, the signs of atropinization may occur earlier than might be expected when atropine is used alone. This is especially true if the total dose of atropine has been large and the administration of pralidoxime chloride has been delayed. Excitement and manic behavior immediately following recovery of consciousness have been reported in several cases. However, similar behavior has occurred in cases of organophosphate poisoning that were not treated with pralidoxime chloride.

    Drug Abuse And Dependence

    PROTOPAM (pralidoxime chloride) is not subject to abuse and possesses no known potential for dependence.

    Read the entire FDA prescribing information for Protopam (Pralidoxime Chloride)

    © Protopam Patient Information is supplied by Cerner Multum, Inc. and Protopam Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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