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Ammonium Chloride



Indications and Usage


  • This orally administered salt causes acidification of the blood and is useful for the removal of strontium from the body, especially when combined with intravenous calcium gluconate.
  • Ammonium chloride is given p.o., 1-2 gm q.i.d., for up to 6 consecutive days.
  • Check blood pH or serum CO2, which will be lowered due to acidification.
  • While best results occur if given quickly after intake, some effect is seen if used up to 2 weeks afterward.
  • If used promptly with calcium gluconate, radiostrontium levels can diminish 40-75%. Nausea, vomiting, and gastric irritation are common.
  • Avoid in patients with severe liver disease.

FDA Product Safety Info

  • Not FDA approved for this indication/off-label use
  • Oral dosing of ammonium chloride is suggested for the use of radium and strontium internal contamination; however, this indication is not approved, there is currently no approved oral dosage form, and the commercial availability of the oral dosage form is not known.
  • Ammonium chloride may be contraindicated in patients with impaired hepatic or renal function.

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References

  1. Marcus, CS. Administration of decorporation drugs to treat internal radionuclide contamination: medical emergency response to radiologic incidents. RSO Magazine, 2004;9(5):9-15. (PDF - 34 KB)
  2. "Radiation Bioterrorism," Tochner ZA, Lehavi O, Glatstein E, Chapter 207 in Harrison's Principles of Internal Medicine, Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, eds. 16th Edition, pp 1294-1300, McGraw-Hill, 2005
  3. Management of Persons Accidentally Contaminated with Radionuclides, National Council on Radiation Protection and Measurements, NCRP Report No. 65, Bethesda, MD, 1980.
 

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U.S. Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response National Library of Medicine