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Table 1 Overview of chelation drugs for mercury intoxication

From: Evaluation of mercury exposure level, clinical diagnosis and treatment for mercury intoxication

Chemical name (common names, abbreviations)

Dose

Adverse effect

Elements chelated

2,3-bis(sulfanyl)butanedioic acid (Dimercaptosuccinic acid; DMSA; Succimer)

10 mg/kg (or 350 mg/m2) q 8 h for 5 days, then 10 mg/kg q 12 h for 14 days (a total of 19 days), P.O.

Gastrointestinal disturbances, mild increase in serum transaminase

Lead, arsenic, mercury, cadmium, silver, tin, copper

Sodium 2,3-bis(sulfanyl)propane-1-sulfonate (Sodium (Dimercaptopropanesulfonate; DMPS; Dimaval)

5 mg/kg q 6–8 h, P.O., I.M.,I.V., SQ

Low back (kidney) pain, gastrointestinal disturbances, skin rash, fatigue, hypersensitivity reactions

Mercury, arsenic, lead, cadmium, tin, silver, copper selenium, zinc, magnesium

Children: 5-day courses of 200 or 400 mg of DMPS per m2 surface area per day

(2S)-2-amino-3-methyl-3-sulfanylbutanoic acid (3-Sulfanyl-D-valine; Penicillamine; D- Penicillamine)

10 mg/kg/d for 7 days with a possibility of a prolonged treatment during 2 to 3 weeks, P.O.

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 q 4 h for 5 days, deep I.M.

Allergy, gastrointestinal symptoms, tachycardia, fever, elevation of liver function tests

Arsenic, gold, mercury, lead (BAL in combination with)