Table 3 Antivenoms against Macrovipera venoms listed by the WHO

From: The biology and toxinology of blunt-nosed vipers

Antivenom name

Manufacturer

Country

IgG type [source]

Specificity

European viper venom antiserum

Imunološki Zavod

Croatia

F(ab')2 [equine]

Vipera ammodytes; manufacturer label claim of paraspecificity: Macrovipera lebetina, Montivipera xanthina, Vipera aspis, Vipera berus

Gamma-Vip

Institut Pasteur de Tunis

Tunisia

F(ab')2 [equine]

Macrovipera lebetina, Cerastes cerastes

Hexavalent snake venom immunoglobulin

Razi Vaccine & Serum Research Institute

Iran

F(ab')2 [equine]

Macrovipera lebetina cernovi, Echis carinatus sochureki, Montivipera raddei, Gloydius caucasicus, Naja oxiana, Pseudocerastes persicus

Inoserp™ Europe

Inosan Biopharma S. A.

Spain

F(ab')2 [equine]

Macrovipera lebetina cernovi, Macrovipera lebetina obtusa, Macrovipera lebetina turanica, Macrovipera schweizeri, Vipera ammodytes, Vipera aspis, Vipera berus, Vipera latastei, Montivipera xanthina

Inoserp™ MENA

Inosan Biopharma S. A.

Spain

F(ab')2 [equine]

Macrovipera lebetina, Bitis arietans, Cerastes cerastes, Echis leucogaster, Montivipera raddei, Naja haje, Naja nigricollis, Naja pallida, Pseudocerastes fieldi, Pseudocerastes persicus, Walterinnesia aegyptia; manufacturer label claim of paraspecificity: Macrovipera lebetina obtusa, Macrovipera lebetina transmediterranea, Macrovipera lebetina turanica, Cerastes gasperettii, Cerastes vipera, Daboia mauritanica, Daboia palaestinae, Echis carinatus sochureki, Echis coloratus, Echis khosatzkii, Echis megalocephalus, Echis omanensis, Echis pyramidum, Montivipera bornmuelleri, Montivipera raddei kurdistanica, Naja nubiae, Naja oxiana, Vipera latastei

IPAVIP Antiviperin Sera

Institut Pasteur d’Algerie

Algeria

IgG2a [equine]

Macrovipera lebetina, Cerastes cerastes

Monovalent serum against snake venom gyurza

UzbioPharm LLC

Uzbekistan

F(ab')2 [equine]

Macrovipera lebetina

Pentavalent snake antivenom immunoglobulin

Razi Vaccine & Serum Research Institute

Iran

F(ab')2 [equine]

Macrovipera lebetina cernovi, Echis carinatus sochureki, Montivipera raddei, Gloydius caucasicus, Pseudocerastes persicus

Polisera

Vetal Serum ve Biyolojik Ürünler Üretim Sanayi ve Ticaret A.Ş.

Türkiye

F(ab')2 [equine]

Macrovipera lebetina, Montivipera xanthina, Vipera ammodytes

Polyvalent Anti-Snake Serum

Egyptian Organisation for Biological Products and Vaccines (VACSERA)

Egypt

F(ab')2 [equine]

Cerastes cerastes, Naja haje, Naja nubiae; manufacturer label claim of paraspecificity: Macrovipera lebetina, Bitis arietans, Bitis gabonica, Cerastes vipera, Daboia palaestinae, Echis coloratus, Echis carinatus, Naja melanoleuca, Naja mossambica, Naja nigricollis, Naja oxiana, Naja pallida, Pseudocerastes persicus, Vipera ammodytes, Walterinnesia aegyptia

Polyvalent Anti-Vipers Serum

Egyptian Organisation for Biological Products and Vaccines (VACSERA)

Egypt

F(ab')2 [equine]

Cerastes cerastes, Echis coloratus, Echis pyramidum; manufacturer label claim of paraspecificity: Macrovipera lebetina, Cerastes vipera, Echis carinatus, Montivipera xanthina, Pseudocerastes fieldi, Vipera ammodytes

Polyvalent serum against snake venoms gyurza, efa, and cobra

UzbioPharm LLC

Uzbekistan

F(ab')2 [equine]

Macrovipera lebetina, Echis carinatus, Naja oxiana

SnaFab5

Padra Serum Alborz

Iran

F(ab')2 [equine]

Macrovipera lebetina cernovi, Echis carinatus sochureki, Gloydius caucasicus, Montivipera raddei, Pseudocerastes persicus

SnaFab6

Padra Serum Alborz

Iran

F(ab')2 [equine]

Macrovipera lebetina cernovi, Echis carinatus sochureki, Gloydius caucasicus, Montivipera raddei, Naja oxiana, Pseudocerastes persicus

  1. For each antivenom, the table provides the name, manufacturer, country of production, type and source of IgG, and immunising/neutralised snake species. Macrovipera taxa are reported in bold. Information was gathered from the WHO Snakebite Information and Data Platform30, the Snakebite Envenoming Medicines Database194, Dalhat et al.203, Dehghani et al.31, Alshalah et al.32, and Jalali et al.193.
  2. IgG immunoglobulin G; F(ab')2 antibody fragment with two antigen-binding sites including part of the hinge region of the antibody.