DIMERCAPROL
Background and Date of Approval
Dimercaprol was approved by the US Food and Drug Administration (FDA) on 06/05/1946 during the Second World War as an antidote for lewisite, an arsenic-based chemical warfare agent.
Uses
Dimercaprol is an effective antidote for treating arsenic, gold, and mercury poisoning, as well as acute lead poisoning as an adjunct with other treatments. This injection is especially useful for acute poisoning caused by mercury salts if you reach the hospital within one or two hours of mercury poisoning. However, it's not very effective for chronic mercury poisoning. Treatment is most successful when started shortly after metal exposure.
How is it administered?
Dimercaprol is available as a 100mg injection for deep intramuscular use (injected deep into your muscle) by your healthcare provider. Your physician will decide the correct dosage and duration based on age, body weight, and disease condition.
Side Effects
Dimercaprol can cause some side effects like any other drug. When you receive this injection, your blood pressure might increase, and your heart may beat faster. The increase in blood pressure and heart rate is usually related to the injection amount you receive. If you get a larger dose than necessary, you might experience some temporary symptoms. These can include feeling nauseous and sometimes even vomiting, having a headache, or sensing a burning feeling in your lips, mouth, and throat. If you ever experience any of these, make sure to let your healthcare provider know. They can adjust your treatment to make you more comfortable.
Warnings
Dimercaprol is not advised for iron, cadmium, or selenium poisoning since it can produce compounds that are more poisonous than the metals themselves, potentially resulting in kidney damage. It is also not recommended if you have severe liver issues except in cases of post-arsenic jaundice. Additionally, if you have a peanut allergy, inform your doctor because this injection contains peanut oil. Engaging in transparent communication with your doctor regarding your medical history and medications is crucial to ensure the safe and proper use of dimercaprol.
Precautions
During your dimercaprol treatment, it is vital to prioritise your safety. If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor before using this medication. Additionally, inform your physician about any existing lung or liver conditions, as dimercaprol may pose risks. Avoid alcohol consumption while undergoing treatment, as it can harm your liver. If you experience dizziness, refrain from driving or operating machinery. Always consult your healthcare provider for personalised guidance to ensure your well-being throughout the course of your treatment.
Word of Advice
During the treatment with dimercaprol for kids, there is a chance of having a fever during the treatment which subsides overtime. The medication is usually eliminated through bile, making it safe for kidney disease patients. The duration of treatment varies based on your response, ranging from two to seven days, so prompt initiation is crucial. If you encounter any issues, consult your doctor immediately and heed their advice. To safeguard your kidneys during dimercaprol therapy, your doctor might prescribe a urinary alkalizer to maintain a balanced urine pH. This helps preserve kidney function. Your healthcare team will monitor factors like blood and urine levels, symptom improvement, and potential side effects. It's vital to closely follow your doctor's instructions as they keep a close watch on these factors to ensure the treatment's effectiveness and your kidney's safety. Stay informed and maintain open communication with your healthcare provider about any concerns you may have.
References
Taylor Pharmaceuticals, US Food and Drug Administration (FDA), [Revised on Oct 2006] [Accessed on 11th Oct 2023] https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/005939s007lbl.pdf Dawn L, et al., Dimercaprol; Treasure Island (FL); National Library of Medicine; Published on 29/08/2022; Accessed on 11/10/2023; https://www.ncbi.nlm.nih.gov/books/NBK549804/ KD Tripathi, Essentials of Medical Pharmacology, Chelating agents, 8th edition, 2019, 964-965 Goodman & Gilmanâs, The Pharmacological Basis of Therapeutics, Environmental Toxicology: Carcinogens and Heavy Metals, 2018, 131
Frequently Asked Questions
What is dimercaprol used for?
Dimercaprol treats heavy metal poisoning, such as lead, arsenic, or mercury. It works by binding to these metals and helping your body eliminate them.
What is the purpose of using a urinary alkalinizer in dimercaprol therapy?
The purpose of using a urinary alkalinizer in dimercaprol therapy is to maintain alkaline urine throughout the treatment. This alkaline environment helps prevent the dissociation of the dimercaprol-metal complex, safeguarding the kidneys and ensuring the effectiveness of the therapy.
What are the common side effects of dimercaprol?
Common side effects include pain at the injection site, fever, and, in some cases, a metallic taste in the mouth. It's essential to report any unusual or severe symptoms to your healthcare provider.
Can I continue my other medications while taking dimercaprol?
It's crucial to inform your healthcare provider about all the medications, supplements, or herbal products you are taking. Some medications may interact with dimercaprol, so your doctor will guide you on which ones are safe to continue.
How long will I need to take dimercaprol?
The duration of dimercaprol treatment varies based on the type and severity of heavy metal poisoning. Your healthcare provider will determine the length of the treatment course. It's essential to complete the prescribed treatment even if you start feeling better to ensure the effective removal of the toxic metals from your body.