Succimer (DMSA) is an orally active metal chelator is used to treat heavy metal poisoning. In adults Succimer is used for symptomatic lead poisoning or in patients who are asymptomatic with levels >60 micrograms/dL (>2.9 micro mol/L). In paediatrics it is used for symptomatic lead poisoning or in patients who are asymptomatic with levels >45 micrograms/dL (>2.17 micro mol/L).
- Administer 10 mg/kg orally 3 times/day for 5 days. Then…. 10 mg/kg orally 2 times/day for 14 days.
- Blood levels are required following completion of the initial course of succimer.
- In those that are critically unwell the use of sodium calcium edetate is recommended.
- Adverse reactions include gastrointestinal upset, transient liver function abnormalities in 60% and reversible neutropenia.
- Bradberry S, Vale A. Dimercaptosuccinic acid (succimer; DMSA) in inorganic lead poisoning. Clinical Toxicology 2009; 47; 617-631.
- Dietrich KN et al. Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics. 2004 Jul;114(1):19-26.
Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.