500mg/20 mL vials


To treat poisoning of organophosphates or chemical nerve agents.

Medication box with the name PAM Pralidoxime Iodide Injection. A vial next to the box.

Consultation with a clinical toxicologist is recommended through local toxicology service or Poisons Information Centre  13 11 26.


1g – 2g (child 15mg/kg) in 100 mL sodium chloride 0.9% over 15 mins, then 250-500mg/hour (child 10mg/kg/hour).

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre
0 – 10 vials 0 vials 0 vials 0 vials


Organophosphate poisoning within Australia is uncommon. Life-saving treatment involves atropinisation and ventilation. A Cochrane review found insufficient evidence to support the routine use of pralidoxime. It may be associated with increased harm. Pralidoxime is rarely recommended by clinical toxicologists.


Fact sheet developed by Queensland Poisons Information Centre.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.

Last updated: July 2023