Indications for: CHEMET
Lead poisoning in children with blood lead levels >45mcg/dL.
Swallow whole; may put contents onto a small amount of soft food or a spoon and swallow, followed by fruit drink. <12mos: not established. ≥12mos: initially 10mg/kg (or 350mg/m2) every 8hrs for 5 days, then reduce frequency to every 12hrs for 14 more days. Allow at least 14 days between courses unless blood lead levels indicate need for more prompt treatment. Treatment for more than 3 consecutive weeks: not recommended.
Not for lead poisoning prophylaxis. Find and remove source of lead from environment. Monitor for rebound elevated lead levels by measuring blood levels at least once weekly until stable. Monitor for neutropenia; withhold or discontinue if ANC <1200/mcL and only rechallenge if benefits outweigh risks. Monitor for infection, rash. Obtain CBC, serum transaminases prior to initiation and weekly during treatment. History of hepatic dysfunction (monitor). Renal impairment. Maintain adequate hydration. Pregnancy. Nursing mothers: not recommended.
Concomitant other chelation therapy (eg, EDTA): not recommended (may use Chemet for subsequent treatment after an interval of 4 weeks). False (+) results with nitroprusside test (eg, Ketostix).
GI upset, elevated serum transaminases, rash, pain, cramps, flu-like symptoms, dizziness, drowsiness, nasal congestion; neutropenia, mucocutaneous vesicular eruptions (rare).