Succimer
Mechanism :
Succimer is an analog of dimercaprol. It forms water soluble chelates with heavy metals which are subsequently excreted renally.
Indication :
- Treatment of lead poisoning in children with serum lead levels >45 mcg/dL
- Off-label: arsenic poisoning, mercury poisoning.
Contraindications :
Hypersensitivity to succimer or any component of the formulation
Dosing :
Oral:
10 mg/kg/dose (or 350 mg/m²/dose) every 8 hours for 5 days and then every 12 hours for 14 days. Maximum: 500 mg/dose.
Treatment courses may be repeated, but a 2-week interval between courses is generally recommended because lead re-equilibrates between the extravascular storage sites (e.g., bone) and the vascular compartment.
Adverse Effect :
Metallic taste, decreased appetite, diarrhea, haemorrhoids, loose stools, nausea, vomiting, Cardiac arrhythmia, Chills, dizziness, drowsiness, fatigue, Skin rash, Increased serum cholesterol, Change in platelet count (increase), eosinophilia, Increased serum alkaline phosphatase, increased serum AST & ALT, Cloudy vision (cloudy film in eye), watery eyes.
Interaction :
No known significant interactions.
Hepatic Dose :
No dose adjustment recommended. Use cautiously and monitor serum transaminases frequently, as there can be transient increases in enzyme levels.