Iron-

Do not administer to patients under therapy with dimercaprol

Treatment of poisoning of Iron, arsenic, gold, mercury, lead

Hypertension, CNS stimulation, Nausea, vomiting, Burning sensation of lips, Mouth, throat and eyes, Muscles and abdominal pain. Headache, parathesias, fever. Haemolytic anaemia (G6PD defeciency).

Hepatic or renal efficiency, except postarsenical jaundice Iron,lead,cadmium and organic mercury poisoning.

Special precautions: Caution in hepatic/renal damage and in hypertensive patients. Urinary alkalinazation recommended because the dimercaprol -metal complex breaks down easily in acid medium. Alkaline urine protects the kidney during therapy. G-6-PD deficiency- use with caution in these patients especially in the presence of infection or other stressful situations,hemolysis may occur.

Warnings-

Other metal poisioning- dimercaprol is of a questionable value inmetal poisioning other than those listed indications (eg antimony, bismuth).

Renal/hepatic function impairment- do not use innhepatic insufficiency. Discontinue or use only with extreme caution if acute renal insufficiency develops during therapy.

Pregnancy- use caution when administering to a nursing woman.

Children- fever may persist during therapy(30%). A transcient reduction of the percentage of polymorphonuclear leukocytes also occur.

Indications:

Arsenic, gold, and mercury poisoning.

Dosage:

Mild poisoning - 2.5mg/kg 4 times a day, for 2 days, then 2 times on the third day and once daily for 10 days. Severe poisoning- 3mg/kg 4 times a day, for 2 day then 4 times on third day and once daily for 10 days.

Mercury poisoning-

5mg/kg initially followed by 2.5mg/kg 1 or 2 times for 10 days.

Overdosage-

Dosage exceeding 5mg/kg will usually be followed by- nausea, vomiting, headache, burning sensation in thelips, mouth and throat, feeling of constriction or pain in the throat, chest or hands, conjuntivitis, lacrimation, blepharal spasm, rhinorrhea, salivation, tingling of the hands, burning sensation in the penis, sweating of the forehead, hands and other areas, abdominal pain, local pain at injection sites, occassional appearance of painful sterile abcess. These may be accompanied by anxiety, weakness, and unrest and may be relieved by an antihistamine.

Missed dose-

1. If you miss a dose of this medicine, take it as soon as possible.

2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

Pharmacology:

Dimercaprol promotes excretion of arsenic, gold and mercury by chelation. The dimercaprol sulfhydrl groups form complexes with metals. This increases urinary and fecal elimination of the metals.

Pharmacokinetics:

After IM use, peak concentrations occur in 30 to 60 minutes. It has a short half-life, metabolism and excretion are complete within 4 hours.

Not reported.

Pregnancy:

Do not use unless necessary.

Lactation:

Use caution when administering to nursing woman.

Children:

Fever may persist during therapy(30%). A transcient reduction of the percentage of polymorphonuclear leukocytes also occur.