Adult Dosing

Lead poisoning

• Start dose: 10 mg/kg PO q8hrs x 5 days; followed by dosing q12hrs x 14 days

Note:

• Blood lead levels should be >45 mcg/dL
• May repeat therapy course >q2wk
• May administer by separating the capsule and sprinkling the medicated beads on soft food or fruit drink

Pediatric Dosing

Lead poisoning

>1 yr

• Start dose: 10 mg/kg PO q8hrs x 5 days; followed by dosing q12hrs x 14 days
• 18-35 lbs: 100 mg PO (1 cap)
• 36-55 lbs: 200 mg PO (2 caps)
• 56-75 lbs: 300 mg PO (3 caps)
• 76-100 lbs: 400 mg PO (4 caps)
• >100 lbs: 500 mg PO (5 caps)

Note:

• Blood lead levels should be >45 mcg/dL
• May repeat therapy course >q2wk
• May administer by separating the capsule and sprinkling the medicated beads on soft food or fruit drink

• Treatment of lead poisoning in pediatric patients with blood lead levels >45 mcg/dL

• Hypersensitivity to any of the ingredient of the product

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined; caution advised

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; caution advised

See Supplemental Patient Information

• Keep out of reach of pediatric patients
• Therapy is not a substitute for effective decrease of lead exposure
• Mild to moderate neutropenia has been reported in some patients receiving succimer; CBC, WBC differential and direct platelet counts should be evaluated prior to and weekly during treatment with succimer; withhold or discontinue the therapy if ANC <100/mcgL
• Instruct patient to report any signs of infection after treatment with succimer
• Symptoms associated with elevated blood lead levels may reoccur after discontinuation of therapy; closely monitor the patients for rebound of blood lead levels, by measuring blood lead levels at least once weekly until stable
• Patient receiving succimer should be adequately hydrated; use cautiously in patients with compromised renal function
• Transient mild elevations of serum transaminases have been reported in few patients during the course of succimer; monitor serum transaminases before the start of therapy and at least weekly during therapy, closely monitor the patients with a history of liver disease
• Closely monitor the patients who require repeated courses of succimer

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Hx hepatic disorder
• EDTA or BAL administered within 4 weeks

Supplemental Patient Information

• Instruct patient to maintain adequate fluid intake and to promptly report any indication of infection
• Keep out of reach of pediatric patients
• Therapy is not a substitute for effective decrease of lead exposure

Pregnancy Category:C

Breastfeeding: Safety unknown. As per manufacturer data, many drugs and heavy metals are excreted in human milk, nursing mothers requiring therapy should be discouraged from nursing their infants

• CV: Arrhythmias
• CNS: Drowsiness, dizziness, sensorimotor neuropathy, sleepiness, paresthesia, head pain
• GI: Nausea, vomiting, diarrhea, appetite loss, hemorrhoidal symptoms, loose stools, metallic taste in mouth, abdominal cramps, stomach pain
• HEMA: Neutropenia
• METABOLIC: Increases in serum transaminases, elevated SGPT, SGOT, alkaline phosphatase, elevated serum cholesterol
• DERM: Rash, papular rash, herpetic rash, rash, mucocutaneous eruptions, pruritus
• EENT: Cloudy film in eye, ears plugged, otitis media, eyes watery
• RESP: Throat sore, rhinorrhea, nasal congestion, cough
• MUSC: Back pain
• MISC: Rib pain, chills, flank pain, fever, flu-like symptoms, moniliasis

• Chelating agent; binds with high specificity to ions of lead in the blood to form a water-soluble chelate that is subsequently excreted by the kidneys
• Rapidly and extensively metabolized
• Excreted in urine (9%), feces (39%) and carbon dioxide from the lungs (1%)
• Half-life: 2 days

US Trade Name(s)

• Chemet

US Availability

Chemet

• CAPS: 100 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Emergency/Critical Care

Chelating Agents

Drug Name: Chemet 100 MG Oral Capsule

Ingredient(s): Succimer

Imprint: CHEMET;100

Color(s): White

Shape: Capsule

Size (mm): 22.00

Score: 1

Inactive Ingredient(s): povidone / sodium starch glycolate type a potato / starch, corn / sucrose / gelatin / ferrous oxide / titanium dioxide

Drug Label Author:
Lundbeck Inc.

DEA Schedule:
Non-Scheduled