Lead poisoning
Adult: Asymptomatic poisoning with blood lead levels >70 mcg/dL or symptomatic poisoning without encephalopathy: 167 mg/m2 every 4 hr for 3-5 days; may treat with dimercaprol until blood lead level is <50 mcg/dL. Blood lead levels >70 mcg/dL and/or symptoms of lead encephalopathy: 250 mg/m2 every 4 hr for 5 days with dimercaprol; 1st dose to be given at least 4 hr after the 1st dose of dimercaprol; both drugs may be given simultaneously via deep IM inj at separate sites; if needed, course may be repeated after at least 2 treatment-free days.
Intravenous
Lead poisoning
Adult: Asymptomatic with blood lead levels >70 mcg/dL or symptomatic poisoning without encephalopathy: 1 g/m2/day either via 8-24 hr IV infusion or in divided doses every 12 hr for 3-5 days, repeat if needed, after an interval of at least 2 days without treatment. Symptomatic poisoning with lead encepahlopathy and/or blood lead levels >70 mcg/dL: Initally, dimercaprol 4 mg/kg via IM inj. At least 4 hr later and when adequate urine flow is established, administer dimercaprol at 4 mg/kg every 4 hr via IM inj and sodium calcium edetate at 50 mg/kg/day via 24-hr continuous IV infusion or 1-1.5 g/m2/day either via 8-24 hr infusion or in divided doses every 12 hr for 5 days. Further courses may be repeated after at least 2 days without treatment.
Child: Asymptomatic with blood lead level 45-69 mcg/dl: 25 mg/kg/day for 5 days either via 8-24 hr infusion or divided into 2 doses every 12 hr. Depending on the blood lead level, further courses may be repeated after at least 2-4 treatment-free days.
Child: Asymptomatic with blood lead level 45-69 mcg/dl: 25 mg/kg/day for 5 days either via 8-24 hr infusion or divided into 2 doses every 12 hr. Depending on the blood lead level, further courses may be repeated after at least 2-4 treatment-free days.
Parenteral
Lead nephropathy
Adult: Dosage is based on serum creatinine level. For level ≤2 mg/dL: 1 g daily for 5 days; For level 2-3 mg/dL: 500 mg every 24 hr for 5 days; For level 3-4 mg/dL: 500 mg every 48 hr for 3 doses; For level >4 mg/dL: 500 mg once wkly. May repeat course at 1-mth intervals until lead excretion is reduced toward normal. Doses may be given via slow IV infusion over 8-12 hr (as single daily dose) or deep IM inj.
Parenteral
Diagnosis of lead poisoning
Adult: Mobilisation test: 500 mg/m2 (max: 1 g) by IV infusion over 1 hr or as single IM inj. Urine is collected in lead-free collection container for 24 hr (3-4 days if renally impaired) from the time of drug admin and analysed for lead content. Test is considered positive if ratio of lead (in mcg) excreted in urine to sodium calcium edetate (in mg) administered is >1.
Child: Mobilisation test: 500 mg/m2 (max: 1 g) by IV infusion over 1 hr or as single IM inj. Urine is collected for 24 hr in the lead-free collection container from the time of drug admin and analysed for lead content. Test is considered positive if ratio of lead (in mcg) excreted in urine to sodium calcium edetate (in mg) administered is >1.
Child: Mobilisation test: 500 mg/m2 (max: 1 g) by IV infusion over 1 hr or as single IM inj. Urine is collected for 24 hr in the lead-free collection container from the time of drug admin and analysed for lead content. Test is considered positive if ratio of lead (in mcg) excreted in urine to sodium calcium edetate (in mg) administered is >1.