Some medically important snakes found in the Middle East*

Consult a regional poison control center or clinician with expertise in treating bites caused by Middle Eastern snakes for medical therapy including indications for giving antivenom, specific antivenom to use, and dosing.
Common name	Scientific name	Additional effects	Antivenom
Snakes causing paralysis
Arabian cobra	Naja arabica	Paralysis only	Polyvalent
Central Asian cobra	Naja oxiana	Local^¶ and tissue necrosis	Polyvalent
Long-nosed viper	Vipera ammodytes	Local^¶	Monovalent and polyvalent
Persian horned viper	Pseudocerastes persicus	Paralysis only	Polyvalent
Vipers (Levant viper)	Vipera species and Macrovipera lebetina	Local^¶, coagulopathy, hemorrhage, hypotension, and acute kidney injury	Monovalent and polyvalent
Snakes causing local tissue damage^¶ and systemic illness without paralysis
Carpet and saw-scaled vipers	Echis species	Hemorrhage, coagulopathy, tissue necrosis, and acute kidney injury	Polyvalent
Puff adder	Bitis arietans	Coagulopathy, hemorrhage, tissue necrosis, hypotension, and acute kidney injury	Polyvalent
Palestinian viper	Daboia palaestinae	Tissue necrosis, coagulopathy, rhabdomyolysis, and hypotension	Monovalent and polyvalent

* Antivenom name and manufacturer, comprehensive listings of venomous Middle Eastern snakes by geographical region, and more precise geographic distribution of specific snake species may be found at Toxinology snake search.

¶ Local effects include swelling, blistering, hemorrhagic skin changes, and bruising.

Data from:

White J. Overview of venomous snakes of the world. In: Medical Toxicology, 3rd ed, Dart RC (Ed), Lippincott, Williams, & Wilkins, Philadelphia, 2004, p.1543.
Clinical toxinology resources. www.toxinology.com (Accessed March 26, 2013).
Venomous snakes and antivenoms search interface, World Health Organization.

Graphic 93458 Version 6.0

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Some medically important snakes found in the Middle East*