Brand Name: Chemet
Classification: Chelating Agent
Indications:
- Treatment of lead poisoning in children with serum lead levels >45 mcg/dL
- Treatment of lead poisoning in symptomatic adults
- Antidote of lead poisoning
Mechanism of Action
Succimer is a lead chelator. It forms water soluble chelates with heavy metals and, consequently, increases the urinary excretion of lead. Succimer binds heavy metals; however, the chemical form of these chelates is not known.
Contraindications
- CHEMET should not be administered to patients with a history of allergy to the drug.
- CHEMET is not indicated for prophylaxis of lead poisoning in a lead-containing environment.
Special Precautions
- Succimer is not a substitute for effective abatement of lead exposure.
- Hepatic impairment: Use with caution in patients with hepatic impairment; monitor serum transaminase levels closely
- Renal impairment: Use with caution in patients with renal impairment. Succimer is dialyzable, however, the lead chelates are not.
- Encephalopathy: Succimer does not cross blood brain barrier and should not be used to treat encephalopathy associated with lead toxicity.
- Lead poisoning: Investigate, identify, and remove sources of lead exposure prior to treatment. Succimer is not used to prevent lead poisoning. Primary care providers should consult experts in chemotherapy of lead toxicity before using chelation drug therapy.
- Pregnancy
- Lactation
- Dehydration
Adverse Reactions
- Decreased appetite
- Diarrhea
- Metallic taste
- Loose stools
- Nausea and vomiting
- Arrhythmia
- Chills
- Dizziness
- Drowsiness
- Fatigue
- Fever
- Headache
- Sleepiness
- Rash
- Pruritus
- Abdominal cramps
- Mucosal irritation
- Sore throat
- Proteinuria (adults
- Urine output decreased (adults)
- Voiding difficulty (adults)
- Alkaline phosphatase increased
- ALT increased
- AST increased
- Back pain
- flank pain
- leg pain (adults)
- neuropathy
- paresthesia
- rib pain
- Cloudy film in eye
- watery eyes
- Otitis media
- plugged ears
- Cough
- nasal congestion
- rhinorrhea
- Flu-like syndrome
- Moniliasis
Nursing Responsibilities
- The nurse should instruct the patient to maintain adequate fluid intake.
- Patients should be instructed to promptly report any indication of infection, which may be a sign of neutropenia.
- The medication should be kept out of children’s reach.
- In young pediatric patients unable to swallow capsules, the contents of the capsule can be administered in a small amount of food.
- It is not known whether this drug is excreted in human milk. Because many drugs and heavy metals are excreted in human milk, nursing mothers requiring CHEMET therapy should be discouraged from nursing their infants.
