CroFab reconstitution in various media: an in vitro solubility study.

Background. We investigated the solubility of Crotalidae Polyvalent Ovine Immune Fab antivenom (CroFab®, Savage Labs and Protherics Inc., Brentwood, TN, USA) in solutions not listed in the Food and Drug Administration (FDA)-approved product package insert. We also assessed whether adsorption to plastic tubing occurs with CroFab® preparations. Methods. Nine vials of expired CroFab® were divided into three groups according to the solution used for reconstitution. Assignment to the solution groups of normal saline, lactated Ringer's solution, or half-normal saline (NS, LR, 1/2NS) was blinded. The antivenom was diluted to a final volume of 75 mL of test solution. Protein concentration was measured after reconstitution, after storage at 4–6°C for 4 h, and after passage through plastic intravenous (IV) tubing. Results. Higher measured protein yields were noted when half-normal saline was used in comparison with normal saline at each step of the study. Lactated Ringer's solution yielded higher protein concentrat...