Dimercarprol

Dimercarprol is a chelating agent used for reversing arsenic, gold, mercury, or lead poisoning.

• Dimercarprol is available under the following different brand names: BAL.

Common side effects of Dimercarprol include:

• weakness,
• headache,
• fever (especially in children), and
• pain or a hard lump where the medicine was injected

Serious side effects of Dimercarprol include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe drowsiness,
• severe headache,
• severe nausea or vomiting,
• stomach pain,
• pain or pressure in the throat or chest,
• anxiety,
• restless feeling,
• rapid heartbeats,
• pain, tingling, or tight feeling in the hands,
• burning sensation in the mouth and throat,
• burning sensation in the penis,
• red or watery eyes,
• twitching eyelids,
• runny nose,
• increased salivation,
• little or no urination,
• painful or difficult urination,
• swelling in the feet or ankles,
• tiredness, and
• shortness of breath

Rare side effects of Dimercarprol include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Injectable solution

• 100 mg Dimercarprol-210 mg benzyl benzonate-680 mg peanut oil/mL

Arsenic/Gold Poisoning

Adult and pediatric dosage

• Day 1-2: 10-12 mg/kg/day divided every 6 hours deep IM for 2 days  
• Day 3: 5-6 mg/kg/day divided every 12 hours deep IM for 1 days
• Day 4-14: 2.5-3 mg/kg deep IM every day for 11 days
• Severe gold dermatitis: 2.5 mg/kg IM every 4 hours for 2 days, then twice daily for a week
• Gold-induced thrombocytopenia: 100 mg IM twice daily for 15 days

Mercury Poisoning

Adult and pediatric dosage

• Day 1: 5 mg/kg deep IM every day for a day  
• Day 2-11: 2.5 mg/kg deep IM every 12-24 hours for 10 days

Lead Poisoning

Adult and pediatric dosage

• Initial 4 mg/kg (75-83 mg/sq. meter) IM  
• Repeat dose at least 4 hours later (but not until adequate urine flow established), THEN
• 4 mg/kg (75-83 mg/sq. meter) + EDTA 250 mg/sq. meter IM every 4 hours for 3-5 days
• If blood lead concentration rebounds to more than 45 mcg/dL [2.174 micromoles/L] within 5-7 days, may repeat course of treatment (usually just EDTA without Dimercarprol)

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug Dimercarprol and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Dimercaprol has no noted severe Dimercarprol with any other drugs.
• Dimercaprol has no noted serious Dimercarprol with any other drugs.
• Dimercaprol has no noted moderate Dimercarprol with any other drugs.
• Dimercaprol has no noted minor Dimercarprol with any other drugs.

This information does not contain all possible Dimercarprol or adverse effects. Visit the RxList Drug Interaction Checker for any drug Dimercarprol. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Hypersensitivity/allergy to peanuts or any other component (each mL contains 700 mg peanut oil)
• Hepatic insufficiency (except postarsenical jaundice)
• Not to be administered IV

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Dimercarprol?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Dimercarprol?”

Cautions

• Do not use in iron, cadmium, or selenium due to formation of toxic complexes
• Use with other agents (CaNa-EDTA) in acute lead poisoning
• Oliguria, G6PD deficiency
• Discontinue if renal failure occurs

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy.
• Lactation
  • Excretion in milk unknown; use with caution