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Dimercaprol (British Anti-Lewisite [BAL])

Presentation

100mg/2mL vial

*SAS*

Role

Dimercaprol is a parenteral chelating agent, used in the treatment of heavy metal toxicity (lead, arsenic, gold and mercury toxicity).

  • ALERT – All cases should be discussed with a clinical toxicologist through local toxicology service or Poisons Information Centre 13 11 26.

Dose

4mg/kg IM q4h for 5-7 days

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre

0 – 24 vials

0 vials 0 vials 0 vials

Rationale

Dimercaprol is one of several chelating agents available. Its unfavourable side-effect profile means it is rarely the chelation agent of choice. 24 vials are enough to treat a 100kg person for 24 hours.

Precaution

Dimercaprol is frequently associated with adverse effects including severe local pain, hypertension, tachycardia, vomiting, seizures and coma. It is the preferred parenteral chelation agent in renal failure.  It is formulated in a peanut oil suspension and is not suitable for patients with a peanut allergy.

Disclaimer

Fact sheet developed by Queensland Poisons Information Centre, Updated: July 2020.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.

CHQ