succimer

Contraindicated in:

Hypersensitivity
Lactation: Lactation.

Use Cautiously in:

Renal failure (chelates are not dialyzable)
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
Pedi: Children <1 yr (safety and effectiveness not established); ↑ risk of bradyarrhythmias in children; children with skeletal muscle myopathy (more prone to rare, but serious, adverse reactions)
Geri: Use lower doses in older adults to adjust for ↓ renal, hepatic and cardiac function.

Adv. Reactions/Side Effects ⬆ ⬇

CV: arrhythmias.

Derm: mucocutaneous eruptions, pruritus, rash.

EENT: otitis media, watery eyes, cloudy film in eye, plugged ears.

GI: nausea, vomiting, elevated liver function tests, abdominal cramps, anorexia, diarrhea, hemorrhoidal symptoms, metallic taste.

GU: oliguria, proteinuria, voiding difficulty.

Hemat: eosinophilia, thrombocytosis.

MS: leg pain, back, rib, flank pain.

Neuro: drowsiness, dizziness, headache, paresthesia, sensorimotor neuropathy.

Resp: cough, nasal congestion, rhinorrhea, sore throat.

Misc: chills, fever, flu-like syndrome, HYPERSENSITIVITY REACTIONS (INCLUDING ANGIOEDEMA AND URTICARIA), moniliasis.

Interactions ⬆ ⬇

Drug-Drug:

Not recommended for use with other chelating agents.

Availability ⬆ ⬇

Capsules: 100 mg;

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥1 yr): 10 mg/kg (350 mg/m²) every 8 hr for 5 days, then ↓ to 10 mg/kg (350 mg/m²) every 12 hr for 2 more wk. Repeated courses should follow a 2-wk rest period.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Forms a water-soluble compound with lead, allowing urinary elimination of excessive amounts of lead.

Therapeutic Effects:

Decreased blood lead levels and decreased target organ damage in lead poisoning.

Classifications ⬆ ⬇

Therapeutic Classification: antidotes

Pharmacologic Classification: chelating agents

Pharmacokinetics ⬆ ⬇

Absorption: Rapidly but variably absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Extensively metabolized; 10% excreted unchanged by the kidneys.

Half-life: 2 days.

Time/Action Profile ⬆ ⬇

(urinary lead excretion)

ROUTE	ONSET	PEAK	DURATION
PO	within 2 hr	2–4 hr	8–12 hr

Patient/Family Teaching ⬆ ⬇

Discuss need for follow-up appointments to monitor lead levels. Additional treatments may be necessary.
Instruct patient to drink adequate fluids during therapy.
Advise patient to notify health care professional if rash occurs.
Consult public health department regarding potential sources of lead poisoning in the home, workplace, and recreational areas. Chelation therapy cannot be used as prophylaxis for lead poisoning.
Rep: May be teratogenic. Advise females of reproductive potential to use effective contraception and avoid breastfeeding during therapy. Advise patient to notify health care professional promptly if pregnancy is suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇