Dimercaprol (British AntiLewisite, BAL in Oil)

Category:

  • Miscellaneous

Description:

  • Heavy metal antidote (arsenic, gold, mercury, lead)

Indications:

  • Treatment of arsenic, mercury, and mercury poisoning

  • Acute lead poisoning (in conjuction with  cascium edetate disodium)

Contraindications:

  • Hepatic insufficiency (except postarsenic jaundice

  • Iron, cadmium, or selenium poisoning; severe renal disease

Precautions:

  • Pregnancy category D; use only in life threatening poisoning

  • Acute renal insufficiency, G-6-PD deficiency, acidic urine, hypertension

Adverse Reactions (Side Effects):

  • CNS: anxiety, headache, sweating

  • CV: rise in blood pressure; tachycardia

  • EENT: burning sensation in the lips, mouth and throat, conjunctivitis, lacrimation, blepharal spasm, feeling of constriction in the throat, rhinorrhea

  • GI: abdominal pain, nausea, salivation, vomiting

  • GU: burning sensation in the penis

Dosage:

Administer DEEP IM ONLY . Adult and child:

  • Mild arsenic and gold poisoning: 

    • IM 2.5 mg/kg/dose every 6 hours for 2 days

    • then every 12 hours on 3rd day

    • then daily for 10 days thereafter

  • Severe arsenic and gold poisoning: 

    • IM 3mg/kg/dose every 4 hours for 2 days

    • then every 6 hours on 3rd day

    • then every 12 hours thereafter for 10 days

  • Mercury poisoning: 

    • IM 5 mg/kg initially followed by 2.5 mg/kg/dose once to twice daily for 10 days

  • Lead poisoning: 

    • IM 4 mg/kg alone for first dose

    • then 3-4 mg/kg/dose with calcium edetate disodium administered at a separate site every 4 hours for 5-7 days

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