Chelating Agent (Heavy Metals)
PREGNANCY RECOMMENDATION:Limited Human Data—Animal Data Suggest Risk (Maternal Benefit May Outweigh Any Embryofetal Risk)
BREASTFEEDING RECOMMENDATION:*Contraindicated
Two reports describing the use of succimer in human pregnancy have been located. Both exposures occurred after the first trimester, but no adverse newborn effects were reported. The drug is likely to cross the placenta, so some fetal exposure will probably occur. However, this limited human pregnancy experience prevents a complete assessment of embryofetal risk. Embryofetal toxicity was observed in two animal species, but the extent of the dosing compared with human use was not provided. Using this drug during pregnancy should be based on the pros and cons of the mother’s clinical need for treatment versus any potential fetal risk that might occur from exposure.
No reports describing the use of succimer during human lactation have been located. The drug will likely be excreted into breast milk, so some infant exposure will probably occur. *However, because the use of succimer implies poisoning with lead or other heavy metals, these substances might also be excreted into breast milk and cause infant toxicity as well. Therefore, breastfeeding is probably contraindicated in women receiving succimer until the metal toxicity is reversed. If the clinical decision is to use this drug while breastfeeding, the infant should be monitored for the most common reported adult side effects of nausea, abdominal cramps, headache, and various body pains (all leading to irritability), vomiting, diarrhea, appetite loss (monitor infant growth), and fatigue (lethargy).