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Active ingredient: Succimer - Brands, Medical Use, Clinical Data

Brands, Medical Use, Clinical Data

Drug Category

  • Antidotes
  • Chelating Agents

Dosage Forms

  • Capsules (opaque, for oral administration, containing beads coated with 100 mg of succimer)

Brands / Synonyms

Chemet; DMSA; Mpi Dmsa Kidney Reagent

Indications

For the treatment of lead poisoning in pediatric patients with blood lead levels above 45 µg/dL. May also be used to treat mercury or arsenic poisoning.

Pharmacology

Succimer is an orally active, heavy metal chelating agent. It forms water soluble chelates and, consequently, increases the urinary excretion of lead. Succimer is not to be used for prophylaxis of lead poisoning in a lead-containing environment. In addition, the use of succimer should always be accompanied by identification and removal of the source of the lead exposure.

Mechanism of Action

Succimer binds with ions of lead in the blood to a water-soluble complex which is subsequently excreted by the kidneys.

Absorption

Rapid but variable.

Toxicity

Oral LD50 in mice is over 5011 mg/kg. Doses of 2300 mg/kg in the rat and 2400 mg/kg in the mouse produced ataxia, convulsions, labored respiration and frequently death. No case of overdosage has been reported in humans. Limited data indicate that succimer is dialyzable.

Biotrnasformation / Drug Metabolism

Chemical analysis of succimer and its metabolites (primarily mixed disulfides of L-cysteine) in the urine showed that succimer was rapidly and extensively metabolized however the specific site of biotransformation is not known.

Contraindications

CHEMET should not be administered to patients with a history of allergy to the drug.

Drug Interactions

CHEMET is not known to interact with other drugs including iron supplements; interactions have not been systematically studied. Concomitant administration of CHEMET with other chelation therapy, such as CaNa 2 EDTA is not recommended.

Drug/Laboratory Tests Interaction: Succimer may interfere with serum and urinary laboratory tests. In vitro studies have shown succimer to cause false positive results for ketones in urine using nitroprusside reagents such as Ketostix® and falsely decreased measurements of serum uric acid and CPK.

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