Arsenic Toxicity Medication

Updated: May 30, 2017
  • Author: Adam Blumenberg, MD, MA; Chief Editor: David Vearrier, MD, MPH  more...
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Medication

Medication Summary

Chelation should be performed in patients with symptomatic arsenic toxicity, although the evidence of therapeutic benefit from chelation derives largely from animal studies. Chelation is principally useful for acute toxicity. In such cases, chelation should be started as soon as possible, because its efficacy declines rapidly with increasing time after exposure. [23]

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Chelating agents

Class Summary

Bind heavy metals and to hasten excretion. By binding in plasma, they render heavy metals nontoxic.

Dimercaprol (BAL in Oil)

First-line agent available in the US for treating arsenic poisoning. Often in short supply, is one of the antidotes considered essential to be stocked by every ED.

Administered IM q4h, mixed in a peanut oil base. Excreted in urine and bile. May be administered to patients with renal failure.

Succimer (DMSA)

Licensed by the FDA for use only in childhood lead poisoning. Has been used worldwide as a heavy metal chelator and has been efficacious in treating arsenic intoxications. In the US, is only available in a bead-filled oral capsule of 100 mg.

Dimerval (DMPS)

Internationally accepted DOC for treating most heavy metal poisonings. Not licensed for use in the US and must be obtained from Helytex in Houston. Available as either a parenteral or oral form.

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