Drug information of Edetate Calcium Disodium

Edetate Calcium Disodium

Drug group:

It is used to get rid of lead from the body.

Mechanism of effect

Calcium is displaced by divalent and trivalent heavy metals, forming a nonionizing soluble complex with lead that is excreted in the urine

Pharmacodynamic

Storage
Store at 25°C (77°F); excursion permitted to 15°C to 30°C (59°F to 86°F

Metabolism
Almost none of the drug is metabolized
Absorption
IM, SubQ: Well absorbed; Oral: <5%
Distribution
Into extracellular fluid; minimal CSF penetration (~5%)
Excretion
Urine (as metal chelates or unchanged drug); decreased GFR decreases elimination
Onset of Action
Chelation of lead: IV: 1 hour; Maximum excretion of chelated lead with IV administration: 24 to 48 hours
Half life
20-60 minutes

Drug indications

Treatment of symptomatic acute and chronic lead poisoning

Dosage

Usual Adult Dose for Lead Poisoning - Mild
For asymptomatic adult patients whose blood lead level is < 70 mcg/dL but > 20 mcg/dL (World Health Organization recommended upper allowable level):
1000
mg/m2/day given intravenously or intramuscularly

Duration of therapy: 5 days; allow 2 to 4 days for lead redistribution and to prevent severe depletion of zinc and other essential metals
-Two courses of treatment are usually employed, depending on severity of lead toxicity and patient tolerance of treatment

Blood lead level over 70 mcg/dL: Use in conjunction with BAL (dimercaprol) is recommended
Consult published protocols and specialized references for combination therapy dosage recommendations

Usual Adult Dose for Lead Poisoning - Severe
For asymptomatic adult patients whose blood lead level is < 70 mcg/dL but > 20 mcg/dL (World Health Organization recommended upper allowable level):
1000
 mg/m2/day given intravenously or intramuscularly
Duration of therapy: 5 days; allow 2 to 4 days for lead redistribution and to prevent severe depletion of zinc and other essential metals
Two courses of treatment are usually employed, depending on severity of lead toxicity and patient tolerance of treatment.

Blood lead level over 70 mcg/dL: Use in conjunction with BAL (dimercaprol) is recommended
Consult published protocols and specialized references for combination therapy dosage recommendations

Usual Pediatric Dose for Lead Poisoning - Mild
For asymptomatic pediatric patients whose blood lead level is < 70 mcg/dL but > 20 mcg/dL (World Health Organization recommended upper allowable level):
1000
mg/m2/day given intravenously or intramuscularly
Duration of therapy: 5 days; allow 2 to 4 days for lead redistribution and to prevent severe depletion of zinc and other essential metals
-Two courses of treatment are usually employed, depending on severity of lead toxicity and patient tolerance of treatment.

Blood lead level over 70 mcg/dL: Use in conjunction with BAL (dimercaprol) is recommended
-Consult published protocols and specialized references for combination therapy dosage recommendations.
Usual Pediatric Dose for Lead Poisoning - Severe
For asymptomatic pediatric patients whose blood lead level is < 70 mcg/dL but > 20 mcg/dL (World Health Organization recommended upper allowable level):
1000
mg/m2/day given intravenously or intramuscularly
Duration of therapy: 5 days; allow 2 to 4 days for lead redistribution and to prevent severe depletion of zinc and other essential metals
-Two courses of treatment are usually employed, depending on severity of lead toxicity and patient tolerance of treatment.

Blood lead level over 70 mcg/dL: Use in conjunction with BAL (dimercaprol) is recommended
-Consult published protocols and specialized references for combination therapy dosage recommendations.

Drug contraindications

Active renal disease or anuria; hepatitis

Side effects

Frequency not defined.
Cardiovascular: Cardiac arrhythmia, ECG changes, hypotension, local thrombophlebitis (IV infusion when concentration >5 mg/mL)
Central nervous system: Chills, fatigue, headache, malaise, numbness, paresthesia
Dermatologic: Cheilosis, dermatitis, skin rash
Endocrine & metabolic: Glycosuria, hypercalcemia, hypokalemia, iron deficiency (with chronic therapy), magnesium deficiency (with chronic therapy), polydipsia, zinc deficiency (with chronic therapy)
Gastrointestinal: Anorexia, gastrointestinal irritation, nausea, vomiting
Genitourinary: Nephrosis, nephrotoxicity, occult blood in urine, proteinuria, urinary frequency, urinary urgency
Hematologic & oncologic: Anemia, bone marrow depression (transient)
Hepatic: Decreased serum alkaline phosphatase, increased liver enzymes (mild)
Local: Pain at injection site (intramuscular)
Neuromuscular & skeletal: Arthralgia, myalgia, tremor
Ophthalmic: Lacrimation
Renal: Renal tubular necrosis
Respiratory: Nasal congestion, sneezing
Miscellaneous: Fever

Alerts

This medicine can cause very bad and sometimes deadly health problems. This medicine may also cause raised pressure in the brain that could cause death. The rate of death in children has been high. The doctor will decide the best way to give edetate CALCIUM disodium. Talk with the doctor

Fatality Risk
Risk of potentially fatal toxic effects
Possible lethal increase in intracranial pressure following IV infusion in patients with lead encephalopathy and cerebral edema. Manufacturer recommends IM administration in this patient population. If administered IV, avoid rapid infusion.
Follow dosage schedule; do not exceed recommended daily dose

Encephalopathy Risk
Lead encephalopathy occurs rarely in adults; occurs more often in pediatric patients, in whom encephalopathy may be incipient and overlooked and results in high mortality rate

Points of recommendation

What do I need to tell my doctor BEFORE I take Edetate CALCIUM Disodium
If you have any of these health problems: Kidney disease or liver disease
If you are not able to pass urine

Have blood work checked as you have been told by the doctor

Have your urine checked as you have been told by your doctor

You may need to have an ECG checked before starting edetate CALCIUM disodium and while taking it

Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using edetate CALCIUM disodium while you are pregnant

Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby

IV or intramuscular administration are equally effective; the intramuscular route is preferred by some for young pediatric patients

In cases where the IV route is necessary, avoid rapid infusion

Establish urine flow prior to the first dose, as this drug is eliminated almost exclusively in the urine; however avoid excessive fluid in patients with encephalopathy

Pregnancy level

B

B

Breast feeding warning

excretion in milk unknown; use with caution

Drug forms

Calcium Disodium Versenate

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