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Table 1 Overview of chelation drugs

From: Evaluation and management of lead exposure

Chemical name (common names, abbreviations) Dose Adverse effects Elements chelated
2,3-bis(sulfanyl)butanedioic acid (Dimercaptosuccinic acid; DMSA; Succimer) 10 mg/kg (or 350 mg/m2) per 8 h for 5 days, then 10 mg/kg per 12 h for 14 days (a total of 19 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 400 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) 10 mg/kg/day for 7 days with a possibility of a prolonged treatment during 2 to 3 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)
  1. a PO oral ingestion
  2. b IM intramuscular injection
  3. c IV intravenous injection
  4. d SQ subcutaneous injection