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dimercaprol

V03AB09

Forms & Strengths

Injection: 100 mg/mL in 3 mL ampoules (in peanut oil)

Adult Dosing

Severe arsenic or gold poisoning: 2.5 to 3 mg/kg intramuscularly every 4 hours for 2 days; then every 6 hours on day 3; then every 12 hours for 10 days
Lead poisoning (with EDTA): 4 mg/kg (first dose) then 3 mg/kg every 4 hours with calcium EDTA for 2 to 7 days
Mercury poisoning: 5 mg/kg initially, then 2.5 mg/kg once or twice daily for 10 days

Pediatric Dosing

Same mg/kg basis as adult dosing adjusted for body weight and specific heavy metal toxicity

Indications

Treatment of acute poisoning by arsenic, gold, and mercury
Adjunctive treatment of severe lead encephalopathy (used in combination with calcium EDTA)

Mechanism of Action

Contains vicinal sulfhydryl groups that compete with endogenous sulfhydryl enzymes for binding with heavy metal ions, forming stable, non-toxic, water-soluble ring-like chelates that are excreted renally

Contraindications

Known hypersensitivity to dimercaprol
Cadmium, iron, selenium, or uranium poisoning (forms toxic complexes)
Hepatic impairment (except when due to gold poisoning)

Adverse Reactions

Transient rise in blood pressure and tachycardia
Nausea, vomiting, and headache
Burning sensation in the lips, mouth, and throat
Pain and sterile abscess at the injection site
Fever in children, nephrotoxicity, and hemolysis in G6PD-deficient patients

Drug Interactions

Iron preparations: should not be administered concurrently as toxic complexes are formed
Cadmium, mercury, and lead complexes can redistribute to the brain if dimercaprol is given alone for cadmium or iron

Curated Content: Needs Vetting Before Put to Clinical Use