Succimer
- Atc Codes:V03AB
- CAS Codes:304-55-2
- PHARMGKB ID:304-55-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
France: Succicaptal; Greece: Succicaptal.
North America
USA: Chemet.
Drug combinations
Chemistry
Succimer: C~4~H~6~O~4~S~2~. Mw: 182.22. (1) Butanedioic acid, 2,3-dimercapto-, (R*,S*)-; (2) meso-2,3-Dimercaptosuccinic acid. CAS-304-55-2 (1978).
Pharmacologic Category
Heavy Metal Antagonists. Antidotes. (ATC-Code: V03AB).
Mechanism of action
An analog of dimercaprol. Forms water soluble chelates with heavy metals which are subsequently excreted renally. Binds heavy metals.
Therapeutic use
Lead poisoning in children with serum lead levels >45 µg/dL.
Pregnancy and lactiation implications
Following maternal occupational exposure, lead crosses placenta in amounts related to maternal plasma levels and may cause spontaneous abortion, postnatal developmental delay, and reduced birth weight. Chelation therapy during pregnancy is for maternal benefit only and should be limited to treatment of severe, symptomatic lead poisoning. Excretion in breast milk unknown (not recommended in nursing women). Calcium supplementation may reduce amount of lead in breast milk.
Unlabeled use
Lead poisoning in symptomatic adults.
Contraindications
Hypersensitivity to succimer or any component of the formulation.
Warnings and precautions
Not used to prevent lead poisoning. Does not cross blood-brain barrier and should not be used to treat encephalopathy associated with lead toxicity. Use with caution in hepatic/renal impairment. Succimer is dialyzable; however, lead chelates are not. Rebounding serum lead levels may occur after treatment as lead is released from storage sites into blood. May cause false-positive ketones using nitroprusside methods, falsely decreased serum CPK, and falsely decreased uric acid measurement.