Dimercaprol

Also known as: BAL

Drug #246

Dimercaprol is a metal complexing agent, used as antidote to poisoninig by arsenic, mercury, lead and sometimes other metals, administered orally.

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Primary Characteristics

Dimercaprol is also known as BAL.

It is of Synthetic origin and belongs to Dimercaptopropanol.

It is classified in Antidotes pharmacological group.

Molecular Weight: 124.2 · Solubility in Water: 1 in 20 · Solubility in Alcohol: freely miscible · Non-proprietary name: Dimercaprol.

Pharmacokinetics

Absorption: Dimercaprol has an oral bioavailability is 0.5% (±0.5%).

Elimination: it is metabolised via Hepatic, plasma half-life is < 2 hr, renal excretion is major.

Indications

Dimercaprol is primarily indicated in conditions like Acute dichloroarsine poisoning, Antimony poisoning, Arsenic poisoning, Lead poisoning, Superficial lesions from heavy metals, Wilson's disease.

Contraindications

Dimercaprol is contraindicated in conditions like Hypertension, Hepatic failure, Iron poisoning, Selenium poisoning, Tellurium poisoning, Cadmium poisoning, Organic mercury poisoning.

Dosage

Dimercaprol's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
2.5 – 3 mg/kg	—	Every 4h	IM	For 2 days.
2.75 mg/kg	2.75 mg/kg	Every 24h	IM
5.714 mg/kg	5.714 mg/kg	Every 12h	IM	2-4 times a day. on third day once daily vntil recovery.
Paediatric Dosage (20kg)
2.75 mg/kg	2.75 mg/kg	Every 8h	Intra Muscular	Initially for 2 Days
2.75 mg/kg	2.75 mg/kg	Every 8h	Intra Muscular	Maintenance
Neonatal Dosage (3kg)
2.75 mg/kg	2.75 mg/kg	Every 4h	Intra Muscular	Initially for 2 Days
2.75 mg/kg	2.75 mg/kg	Every 12h	Intra Muscular	Maintenance

Drug Interactions

None recorded.

Side Effects

Dimercaprol in overdosage may give rise to further complications which include Anemia , Anemia , Anemia, Anemia.

Dimercaprol produces potentially life-threatening effects which include Exacerbation of hypertension, Exacerbation of hypertension, Iron toxicity potentiation. Careful monitoring is needed with proper medical management.

Dimercaprol is known to cause more or less tolerable side effects which are usually transient. These include Abdominal pain, Fever, Headache, Increased BP , Lacrimation, Lip burning sensation, Local pain, Mouth burning sensation, Nausea, Pain at injection site, Sweating , Tachycardia, Tingling of the hand, Vomiting .

Warnings / Precautions

Dimercaprol should be used with caution in patients with hypertension or impaired renal function. It should be discontinued or use with extreme caution if acute renal insufficiency develops during treatment. Alkalinization of the urine may protect the kidney during therapy. Dimercaprol should not be given to patients with impaired hepatic function unless due to arsenic poisoning. It should not be used in the treatment of poisoning due to cadmium, iron or selenium because the dimercaprol-metal complexes formed are more toxic than the metal themselves.

Interference in Pathology

Dimercaprol may interfere in the diagnosis of Elevations of SGPT and SGOT , Thyroid Funtion Test.

Available Brands

None recorded.

Storage Conditions

Dimercaprol should be stored Inj.

Drug Classification

1.4.2.5 — Lead poisoning