Chemical name (common names, abbreviations) | Dose | Adverse effects | Elements chelated |
---|---|---|---|
2,3-bis(sulfanyl)butanedioic acid (Dimercaptosuccinic acid; DMSA; Succimer) | 10Â mg/kg (or 350Â mg/m2) per 8Â h for 5Â days, then 10Â mg/kg per 12Â h for 14Â days (a total of 19Â days), POa. | Gastrointestinal disturbances, mild increase in serum transaminase | Lead, arsenic, mercury, cadmium, silver, tin, copper |
Sodium 2,3-bis(sulfanyl)propane-1-sulfonate (Dimercaptopropanesulfonate; DMPS; Dimaval) | Adult: 5 mg/kg per 6–8 h, PO, IMb, IVc, or SQd. | Low back (kidney) pain, gastrointestinal disturbances, skin rash, fatigue, hypersensitivity reactions | Mercury, arsenic, lead, cadmium, tin, silver, copper, selenium, zinc, magnesium |
Children: 5-day course of 200 or 400Â mg/m2/day | |||
2-[2-[bis(carboxymethyl)amino]ethyl-(carboxymethyl)amino]acetic acid (Ethylenediaminetetraacetic acid; EDTA; CaNa2EDTA) | 1000–1500 mg/m2/day (1–2 g/24 h for a 70-kg adult) as an IV infusion for 5 days | Renal toxicity | Lead, cadmium, zinc |
(2S)-2-amino-3-methyl-3-sulfanylbutanoic acid (3-Sulfanyl-D-valine; Penicillamine; D- Penicillamine) | 10Â mg/kg/day for 7Â days with a possibility of a prolonged treatment during 2 to 3Â weeks, PO. | Interstitial nephritis, hypersensitivity reactions, gastrointestinal disturbances, leukopenia and thrombocytopenia | Copper, arsenic, zinc, mercury, lead |
2,3-bis(sulfanyl)propan-1-ol (Dimercaprol; British Anti-Lewisite; BAL) | 50–75 mg/m2 per 4 h for 5 days, deep IM. | Allergy, gastrointestinal symptoms, tachycardia, fever, elevation of liver function tests | Arsenic, gold, mercury, lead (BAL in combination with CaNa2EDTA) |