Twapam Injection 20 ml belongs to the oxime class of drugs. Pralidoxime is used alone or together with atropine to treat poisoning caused by organic phosphorus pesticides or chemicals. It is also used to treat an overdose of drugs that treat myasthenia gravis.

Twapam Injection 20 ml contains Pralidoxime, a cholinesterase reactivator. It works by reactivating the enzyme cholinesterase (mainly outside the central nervous system), which has been inactivated by phosphorylation due to an organophosphate pesticide or related compound.

A qualified healthcare professional will administer Twapam Injection 20 ml. You may experience mild to moderate pain at the site of injection, blurred vision, diplopia (double vision), impaired accommodation, dizziness, headache, drowsiness, nausea, tachycardia (fast heartbeat), increased systolic and diastolic blood pressure, hyperventilation (rapid or deep breathing), and muscular weakness. Most of these side effects do not require medical attention and gradually resolve over time. However, if the side effects persist, inform your doctor.

Before taking Twapam Injection 20 ml, let your doctor know about all your medical conditions, sensitivities, and ongoing medications. Also, inform your doctor if you are pregnant, planning pregnancy, or breastfeeding. Twapam Injection 20 ml may cause blurred vision and diplopia (double vision); it impacts your ability to drive or operate machinery.

Twapam Injection 20 ml contains Pralidoxime, a cholinesterase reactivator that belongs to the oxime class of drugs. Pralidoxime is together with another medicine called atropine to treat poisoning caused by organic phosphorus pesticides (such as diazinon, malathion, sarin and parathion). Pralidoxime injection is also used to treat an overdose of medicines (such as neostigmine, ambenonium, and pyridostigmine) that treat myasthenia gravis. It works by reactivating the enzymes (cholinesterase) blocked by many pesticides or medicines. Poisoning with these substances or drugs weakens your muscles, including those that let you breathe. Pralidoxime is used to help you regain muscle strength.

• Mild to moderate pain at the site of injection
• Blurred vision
• Diplopia (double vision)
• Impaired accommodation
• Dizziness
• Headache
• Drowsiness
• Nausea
• Tachycardia 
• Increased systolic and diastolic blood pressure
• Rapid or deep breathing
• Muscular weakness

Twapam Injection 20 ml is not recommended as an antidote for carbamate pesticide overdose since it may enhance carbaryl toxicity or known hypersensitivity to the drug. Before taking Twapam Injection 20 ml, inform your doctor of all your medical problems, sensitivities, and medicines. Also, let your doctor know if you are pregnant, want to become pregnant, or are breastfeeding. Do not drive or operate machinery because Twapam Injection 20 ml may cause diplopia (double vision), decreased accommodation, and dizziness.

Drug-Drug Interactions: Twapam Injection 20 ml may interact with neuromuscular blocking agents (e.g. mivacurium) and skeletal muscle relaxants (e.g. succinylcholine).

Drug-Food Interactions: No interactions found.

Drug-Disease Interactions: Twapam Injection 20 ml may interact with disease conditions, including Myasthenia Gravis (muscle weakness) and renal impairment.

• MIVACURIUM
• SUCCINYLCHOLINE

Organophosphorus poisoning occurs after dermal, respiratory, or oral exposure to pesticides or nerve agents. Poisoning can occur after short or long-term exposure. It can cause nerve damage and disrupt hormone production in humans and animals. Organophosphates are also toxic to plants and insects. Agricultural workers and others who handle agricultural chemicals may be at risk, with most exposure occurring in rural areas.