Adult Dosing
Mild arsenic or gold poisoning
- 2.5 mg/kg IM qid x 2 days; bid on third day; thereafter qd x 10 days
Severe arsenic or gold poisoning
- 3 mg/kg IM q4 hrs x 2 days; qid third day; then bid thereafter x 10 days
Mercury poisoning
- Start with 5 mg/kg IM; followed by 2.5 mg/kg IM qd-bid x 10 days
Acute lead encephalopathy
- Start with 4 mg/kg IM; thereafter at 4-hr intervals in combination with edetate calcium disodium injection USP administered at a separate site
- Reduce dose to 3 mg/kg after the first dose for less severe poisoning
- Maintain treatment for 2-7 days depending on clinical response
Note:
- For deep IM use only
- Begin injections at the earliest possible moment and use adequate amounts at frequent intervals
- Use other supportive measures in conjunction with therapy
- Prior to administration, inspect visually for presence of particulate matter and discoloration
- Ensure adequate alkaline urine production
Pediatric Dosing
Mild arsenic or gold poisoning
- 2.5 mg/kg IM qid x 2 days; bid on third day; thereafter qd x 10 days
Severe arsenic or gold poisoning
- 3 mg/kg IM q4 hrs x 2 days; qid third day; then bid thereafter x 10 days
Mercury poisoning
- Start with 5 mg/kg IM; followed by 2.5 mg/kg IM qd-bid x 10 days
Acute lead encephalopathy
- Start with 4 mg/kg IM; thereafter at 4-hr intervals in combination with edetate calcium disodium injection USP administered at a separate site
- Reduce dose to 3 mg/kg after the first dose for less severe poisoning
- Maintain treatment for 2-7 days depending on clinical response
Note:
- For deep IM use only
- Begin injections at the earliest possible moment and use adequate amounts at frequent intervals
- Use other supportive measures in conjunction with therapy
- Prior to administration, inspect visually for presence of particulate matter and discoloration
- Ensure adequate alkaline urine production
- Local pain at the site of the injection have occurred; Fever may persist in children during course of therapy
- A transient reduction of the percentage of polymorphonuclear leukocytes have occurred
- Discontinue therapy or use only with extreme caution on occurrence of acute renal insufficiency during therapy
- Avoid administration of medicinal iron to patients undergoing therapy with the drug
- Allergic reactions may occur in patients having hypersensitivity to peanuts; provide appropriate medication and equipment necessary to treat allergic reactions
- Monitor creatinine at baseline, then periodically
Cautions: Use cautiously in
- Renal impairment
- G6PD deficiency
- Hypertension
- Hypersensitivity to peanuts
Pregnancy Category:C
Breastfeeding: Safety unknown; Unknown whether the drug is excreted in human milk. Manufacturer advises caution.
