Dimercaprol Brand Name– BAL in Oil
What is Dimercaprol
Dimercaprol is an intramuscular heavy metal chelator used in the treatment of acute arsenic, mercury, gold, or lead poisoning.
The drug was developed during World War II in an attempt to discover an antidote to lewisite, a vesicant war gas containing arsenic.
Because arsenicals react with and inhibit SH-containing human enzymes, researchers at Oxford University began searching for a thiol compound that would compete with the SH groups in human tissue and bind the arsenic component of the war gas.
Dimercaprol, a dithiol compound, was found to form a stable, nontoxic chelate ring with the arsenicals and other heavy metals, thereby protecting the tissue against the toxic effects of these chemicals.
Dimercaprol should not be used to treat iron toxicity because the iron-dimercaprol complex is more toxic than the metal itself. Dimercaprol was approved by the FDA for clinical use in 1946.
Indications
- arsenic toxicity
- gold toxicity
- lead toxicity
- mercury toxicity
For the treatment of arsenic toxicity or gold toxicity
for the treatment of mild arsenic toxicity or gold toxicity
Side Effects
- abdominal pain
- anxiety
- conjunctivitis
- diaphoresis
- fever
- headache
- hemolysis
- hyperhidrosis
- hypersalivation
- hypertension
- injection site reaction
- lacrimation
- muscle cramps
- nausea
- neutropenia
- penile irritation
- rhinorrhea
- seizures
- sinus tachycardia
- vomiting
- weakness
Monitoring Parameters
- serum creatinine/BUN
Contraindications
- breast-feeding
- G6PD deficiency
- hepatic disease
- hypertension
- intravenous administration
- oliguria
- peanut hypersensitivity
- pregnancy
- renal disease
- renal failure
- renal impairment
- rheumatoid arthritis
Interactions
- Auranofin
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ferric carboxymaltose
- Ferumoxytol
- Gold
- Gold Sodium Thiomalate
- Iron
- Iron – Injectable Only
- Iron Dextran
- Iron Salts
- Iron Sucrose, Sucroferric Oxyhydroxide
- Polysaccharide-Iron Complex
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Succimer
