{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:18:51Z","timestamp":1777515531522,"version":"3.51.4"},"reference-count":19,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T00:00:00Z","timestamp":1471564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008993","name":"University of Zagreb","doi-asserted-by":"publisher","award":["BM044"],"award-info":[{"award-number":["BM044"]}],"id":[{"id":"10.13039\/100008993","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"Slovenian Research Agency","doi-asserted-by":"publisher","award":["P1-0207"],"award-info":[{"award-number":["P1-0207"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Croatian Research Agency grant","award":["IP-2014-09-4915"],"award-info":[{"award-number":["IP-2014-09-4915"]}]},{"name":"Croatian Research Agency grant","award":["BI-HR\/16-17-002"],"award-info":[{"award-number":["BI-HR\/16-17-002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>ViperfavTM is a commercial F(ab\u2019)2 antivenom prepared against European vipers venom. It is safe and effective for treating envenomation caused by Vipera aspis and Vipera berus. Therapeutic efficacy for treating Vipera ammodytes ammodytes (V. a. ammodytes) envenoming has not been yet described, although protective efficacy has been demonstrated in preclinical studies. We report on a 32-year-old man bitten by V. a. ammodytes who was treated with Viperfav\u2122. Viperfav\u2122 promptly reduced local extension and improved systemic pathological signs, but 24 h after the incident a recurrence of thrombocytopenia occurred despite a favorable pharmacokinetic profile with systemic clearance (1.64 (mL\u00b7h\u22121)\u00b7kg\u22121) and elimination half-life (97 h) among the highest ever reported. The recommended dose of Viperfav\u2122 for V. aspis and V. berus bites may be inadequate for serious V. a. ammodytes envenomations. Following V. a. ammodytes bite, serial blood counts and coagulation profiles should be performed to help guide Viperfav\u2122 treatment, along with supplemental administration as indicated.<\/jats:p>","DOI":"10.3390\/toxins8080244","type":"journal-article","created":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T09:58:27Z","timestamp":1471600707000},"page":"244","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A Single Dose of ViperfavTM May Be Inadequate for Vipera ammodytes Snake Bite: A Case Report and Pharmacokinetic Evaluation"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4816-7278","authenticated-orcid":false,"given":"Tihana","family":"Kurtovi\u0107","sequence":"first","affiliation":[{"name":"Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miran","family":"Brvar","sequence":"additional","affiliation":[{"name":"Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zalo\u0161ka cesta 7, 1000 Ljubljana, Slovenia"},{"name":"Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zalo\u0161ka cesta 4, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damjan","family":"Grenc","sequence":"additional","affiliation":[{"name":"Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Zalo\u0161ka cesta 7, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Lang Balija","sequence":"additional","affiliation":[{"name":"Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-0708","authenticated-orcid":false,"given":"Igor","family":"Kri\u017eaj","sequence":"additional","affiliation":[{"name":"Department of Molecular and Biomedical Sciences, Jo\u017eef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Chemistry and Chemical Technology, University of Ljubljana, Ve\u010dna pot 113, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beata","family":"Halassy","sequence":"additional","affiliation":[{"name":"Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Rockefellerova 10, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.toxicon.2011.10.008","article-title":"Epidemiology of snakebites in Europe: A systematic review of the literature","volume":"59","author":"Chippaux","year":"2012","journal-title":"Toxicon"},{"key":"ref_2","first-page":"1929","article-title":"Evaluation de I\u2019immunotherapie anti-viperine par fragments F(ab\u2019)2 purifies (Viperfav\u2122)","volume":"28","author":"Harry","year":"1999","journal-title":"Presse Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3390\/toxins1020100","article-title":"Asp Viper (Vipera aspis) envenomation: Experience of the Marseille Poison Centre from 1996 to 2008","volume":"1","author":"Glaizal","year":"2009","journal-title":"Toxins"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3109\/15563650.2012.660695","article-title":"European viper envenomings: Assessment of Viperfav\u2122 and other symptomatic treatments","volume":"50","author":"Boels","year":"2012","journal-title":"Clin. 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