Chelating Agent (Antidote)
PREGNANCY RECOMMENDATION:Limited Human Data—Animal Data Suggest Potential Risk (Maternal Benefit May Outweigh Any Embryofetal Risk)
BREASTFEEDING RECOMMENDATION:*Contraindicated (Hold Breastfeeding)
No reports describing the use of dimercaprol in the first trimester of pregnancy have been located. A few case reports using the drug in the second and third trimesters were found, and no adverse fetal effects were seen related to the drug. Adverse pregnancy outcomes occurred due to the metal intoxication. The drug will probably cross the placenta, so some fetal exposure will likely occur. Therefore, this limited human pregnancy experience prevents a complete assessment of the embryofetal risk. Animal studies did show embryofetal toxicity in one species at doses of less than 10 times the RHD. However, the maternal benefit, and indirect fetal benefit, for treating heavy metal poisonings appears to outweigh any unknown embryofetal risk. Therefore, if indicated, dimercaprol should not be withheld because of pregnancy.
No reports describing the use of dimercaprol during human lactation have been located. The drug will probably be found in breast milk, so some infant exposure will likely occur. *Because the use of dimercaprol implies poisoning with arsenic, gold, mercury, or lead, these metals will also likely be excreted into breast milk and are toxic to a nursing infant. Therefore, breastfeeding while using this drug is contraindicated. Breastfeeding can be held (pump and discard) until the poisoning is resolved.