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succimer (Rx)Brand and Other Names:Chemet

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 100mg
more...

Lead Poisoning (Off-label)

10 mg/kg PO q8hr for 5 days; follow by 10 mg/kg/dose q12hr for 14 days; not to exceed 500 mg/dose 

Chemical name: meso 2,3-dimercaptosuccinic acid (DMSA)

Arsenic Poisoning (Off-label)

300 mg PO q6hr for 3 days

End point: urinary arsenic <50 mcg/L

Cystine Kidney Stone (Orphan)

Prevention of cystine kidney stone formation in patients with homozygous cystinuria prone to stone development

Orphan indication sponsor

  • Sanofi Winthrop, Inc; 90 Park Ave; New York, NY 10016-1389

Mercury Intoxication (Orphan)

Treatment of mercury intoxication

Orphan indication sponsor

  • Sanofi Winthrop, Inc; 90 Park Ave; New York, NY 10016-1389

Other Information

Key point: Patient should maintain PO fluids

Forms water-soluble chelate with heavy metal (lead, also mercury and arsenic)

Recheck blood lead levels q14Days

Other Indications & Uses

Lead poisoning (child: >45-69 mcg/dL [2.17-3.33 micromoles/L])

Off-label: arsenic poisoning (in combination with BAL)

Dosage Forms & Strengths

capsule

  • 100mg
more...

Lead Poisoning

<1 year: Safety and efficacy not established

1 year or older: Blood lead levels above 45 mcg/dL, 10 mg/kg or 350 mg/sq.meter q8hr for 5 days, then 10 mg/kg or 350 mg/sq.meter q12hr for 14 days 

Other Information

Key point: patient should maintain PO fluids

Recheck blood lead levels q14Days

Chemet: no data for combination with Na2CaEDTA

Lead Poisoning (Off-label)

10 mg/kg PO q8hr for 5 days; follow by 10 mg/kg/dose q12hr for 14 days; not to exceed 500 mg/dose 

Arsenic Poisoning (Off-label)

300 mg PO q6hr for 3 days

End point: urinary arsenic <50 mcg/L

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Adverse Effects

Frequency Not Defined

Nausea/vomiting

Diarrhea

Abd gas/pain

Transient LFTs incr (AST, AP)

Rash

Pruritus

Sore throat

Rhinorrhea

Drowsiness

Paresthesia

Thrombocytosis

Eosinophilia

Possible decr renal function

Fever

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Pregnancy & Lactation

Pregnancy Category: C

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
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Pharmacology

Mechanism of Action

2 sulfhydryl groups capable of complexing to lead making it water soluble

Pharmacokinetics

Rapid but incomplete

Protein binding: Highly bound to albumin

Excretion: Feces (39%), urine (9%)

Time to peak: 1-2 hr (serum)

Half-life elimination: 2 days

Metabolism: Metabolized extensively to succimer cysteine sulfides

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Images

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Formulary

FormularyPatient Discounts

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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