edetate calcium disodium

Contraindicated in:

Anuria;
Active hepatitis.

Use Cautiously in:

Renal impairment (dose ↓ required if serum creatinine >2 mg/dL);
Cardiac arrhythmias;
Lead encephalopathy (should be used concurrently with dimercaprol or succimer);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Geri: Dose ↓ may be necessary because of age-related ↓ in renal function.

Adv. Reactions/Side Effects ⬆ ⬇

CV: arrhythmia, ECG changes (inverted T waves), hypotension

EENT: lacrimation, nasal congestion, sneezing

F and E: excessive thirst, hypercalcemia, zinc deficiency

GI: anorexia, nausea, vomiting

GU: nephrotoxicity, glycosuria, proteinuria

Hemat: anemia

Local: pain(at IM site), phlebitis

MS: arthralgia, myalgia

Neuro: numbness, tingling, tremor, headache

Misc: chills, fever

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Solution for injection: 200 mg/mL

Route/Dosage ⬆ ⬇

IM IV (Adults and Children ): 1000 mg/m²/day for 5 days (not to exceed 2 g/day). May be repeated after 2–4 day rest period. May be given as an infusion over 8–12 hr or in divided doses IM every 8–12 hr.

Renal Impairment

IM IV (Adults ): The following regimens may be repeated at monthly intervals until lead excretion is reduced toward normal.Serum creatinine 2–3 mg/dL: 500 mg/m²/day for 5 days.Serum creatinine 3–4 mg/dL: 500 mg/m² every 48 hr for 3 doses.Serum creatinine >4 mg/dL: 500 mg/m²/wk.

Action ⬆ ⬇

Removes toxic amounts of lead or other divalent or trivalent cations by their displacement of calcium in edetate calcium disodium. Result is a soluble complex that is excreted by the kidneys.

Therapeutic effects:

Removal of toxic amounts of lead from the blood and other tissues.

Classifications ⬆ ⬇

Therapeutic Classification: antidotes

Pharmacologic Classification: chelating agents

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following IM administration. IV administration results in complete bioavailability.

Distribution: Distributed to extracellular fluid. Does not cross the blood-brain barrier.

Metabolism/Excretion: Rapidly excreted by the kidneys as unchanged drug or lead complex.

Half-Life: 20–60 min.

Time/Action Profile ⬆ ⬇

(urinary lead excretion)

ROUTE	ONSET	PEAK	DURATION
IM	unknown	unknown	unknown
IV	1 hr	24–48 hr	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose of edetate calcium disodium to patient and parents.
Home Care Issues: Discuss need for follow-up appointments to monitor lead levels. Additional treatments may be necessary.
- Consult public health department regarding potential sources of lead poisoning in the home, workplace, and recreational areas.
Rep: Advise female patient of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇