Indications and Usage

  • Dimercaprol effectively chelates radioactive and stable nuclides of mercury, lead, arsenic, gold, and polonium-210.
  • Dimercaprol is an FDA-approved treatment for arsenic, gold, and mercury poisoning. It is indicated in acute lead poisoning when used concomitantly with EDTA.
  • Dimercaprol is quite toxic, with about 50% of patients given 6 mg/kg IM developing reactions. These include systolic and diastolic hypertension, tachycardia, nausea, vomiting, chest pain, headache, and sterile abscess at the injection site.
  • Dimercaprol is effective for use in acute poisoning by mercury salts if therapy is begun within 1 to 2 hours following ingestion. Dimercaprol is of unknown value in poisoning caused by other heavy metals such as antimony or bismuth.
  • IM Dosing
    • 2.5 mg/kg QID x 2 days (days 1 & 2)
    • then bid for 1 day (day 3)
    • then qd (days 4-10)
  • It is available as 300 mg/vial for deep IM use (suspension in peanut oil).

FDA Product Safety Info

  • Not FDA approved for this indication/off-label use
  • Adverse events have been reported following use of dimercaprol.
  • Use of dimercaprol has been considered in only the most severe cases of polonium poisoning due to its potential toxicity.
  • Dimercaprol is contraindicated in most instances of hepatic insufficiency.
  • Dimercaprol should be discontinued or used with extreme caution if acute renal insufficiency develops during therapy.

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Drug Label

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  1. Management of Persons Contaminated with Radionuclides: Handbook (NCRP Report No. 161, Vol. I), National Council on Radiation Protection and Measurements, Bethesda, MD, 2008, Decorporation Therapy by Drug (p. 189) and Table 12.5 (p. 190). [Note: NCRP 161 supersedes NCRP 65.]