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 3^rd 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 3^rd 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