Dimercaprol
Indications and Usage
- Dimercaprol effectively chelates radioactive and stable nuclides of mercury, lead, arsenic, gold, and polonium-210.
- Dimercaprol is FDA approved in the treatment of arsenic, gold, and mercury poisoning. It is indicated in acute lead poisoning when used concomitantly with EDTA.
- Dimercaprol is quite toxic, with about 50% of patients given 6 mg/kg IM developing reactions. These include systolic and diastolic hypertension, tachycardia, nausea, vomiting, chest pain, headache, and sterile abscess at the injection site.
- Dimercaprol is effective for use in acute poisoning by mercury salts if therapy is begun within 1 to 2 hours following ingestion. Dimercaprol is of unknown value in poisoning caused by other heavy metals such as antimony or bismuth.
- The dose is
- 2.5 mg/kg (or less) q4h x 2 days,
- then bid for 1 day, and
- then qd for days 5-10
- It is available as 300 mg/vial for deep IM use (suspension in peanut oil).
FDA Product Safety Info
- Not FDA approved for this indication/off-label use
- Adverse events have been reported following use of dimercaprol.
- Use of dimercaprol has been considered in the most severe cases of polonium contamination due to potential toxicity.
- Dimercaprol is contraindicated in most instances of hepatic insufficiency. The drug should be discontinued or used with extreme caution if acute renal insufficiency develops during therapy.
top of page
Drug Label
top of page
|
References |
- 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)
- "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
- Management of Persons Accidentally Contaminated with Radionuclides, National Council on Radiation Protection and Measurements, NCRP Report No. 65, Bethesda, MD, 1980.
|
|