Calcium Disodium Versenate, (edetate calcium disodium) dosing, indications, interactions, adverse effects, and more

Sections

Sections edetate calcium disodium
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Administration
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

200mg/mL

Lead Chelation

Asymptomatic, blood lead 20-70 mcg/dL

1 g/sq.meter IV/IM

Symptoms of lead encephalopathy and/or blood lead level >70 mcg/dL

Use with dimercaprol (BAL) x5 days
IV: 50 mg/kg/day infused over 24 hours, OR 1 g/sq.meter infused over 8-24 hours
IM: 250 mg/sq.meter/dose q4hr
After 5-day therapy completed, wait at least 2 days before deciding to repeat regimen

Lead nephropathy

500 mg/sq.meter IV/IM q24hr x5 days
Serum Cr 3-4 mg/dL: 500 mg/sq.meter IV/IM q48hr x3 doses
Serum Cr >4 mg/dL: 500 mg/sq.meter IV/IM qWeek
May repeat above regimens at 1 month intervals

Other Indications & Uses

Lead poisoning

Lead encephalopathy must be treated with combination BAL preceeding CaNa2EDTA

May be useful for zinc and manganese poisoning & certain heavy radioisotopes

Dosage Forms & Strengths

injectable solution

200mg/mL

Lead Chelation

Asymptomatic, blood lead 20-70 mcg/dL

1 g/sq.meter IV/IM

Symptoms of lead encephalopathy and/or blood lead level >70 mcg/dL

Use with dimercaprol (BAL) x5 days
IV: 50 mg/kg/day infused over 24 hours, OR 1 g/sq.meter infused over 8-24 hours
IM: 250 mg/sq.meter/dose q4hr
After 5-day therapy completed, wait at least 2 days before deciding to repeat regimen

Frequency Not Defined

Renal tubular necrosis

Pain at site

Anorexia

Nausea/vomiting

Cheilosis

Hypercalcemia

Zinc depletion

Dysrhythmias

Inverted T-waves

Bone marrow depression

Anemia

Incr prothrombin times

Malaise

Fatigue

Fever

Chills

Histamine response

Excessive thirst

Black Box Warnings

Edetate calcium disodium is capable of producing toxic effects, which can be fatal. Lead encephalopathy is relatively rare in adults but occurs more often in children in whom it may be incipient and thus overlooked. The mortality rate in children has been high. Patients with lead encephalopathy and cerebral edema may experience a lethal increase in intracranial pressure following intravenous infusion. The intramuscular route is preferred for these patients. In cases where the intravenous route is necessary, avoid rapid infusion. The dosage schedule should be followed, and at no time should the recommended daily dose be exceeded.

Cautions

Oliguria: discontinue if renal failure occurs (dosage adjustment if reduced creatinine clearance)

Pain occurs at inj site

Do NOT use disodium edetate (Na2H2EDTA) for heavy metal toxicity

may cause hypocalcemia-related tetany & even death

Pregnancy & Lactation

Pregnancy Category: B

Lactation: excretion in milk unknown; use with caution

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.

Mechanism of Action

Chelating agent to enhance elimination of metals, particulary lead

Agent being chelated takes place of Ca++

Administration

Use IM in children and pts at risk for lead encephalopathy (may be lethal IV)

Use 1 mL 1% procaine soln, for each mL chelator to minimize pain at injection site

IV: dilute in 250-500 mL NS or D5W with infusion over 1 hr, if asymptomatic

Symptomatic adults require intermittent IV infusion preferably over 12-24 hr, 4 hr after BAL

Monitor renal function closely

Keep pt well hydrated, adequate urine output

Dialysis will remove chelate if pt has renal failure

Images

No images available for this drug.

Patient Handout

NO MONOGRAPH AVAILABLE AT THIS TIME

USES: Consult your pharmacist.

HOW TO USE: Consult your pharmacist.

SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Consult your pharmacist.

DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: No monograph available at this time.

MISSED DOSE: Consult your pharmacist.

STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Formulary

FormularyPatient Discounts

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View the formulary and any restrictions for each plan.
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Compare formulary status to other drugs in the same class.
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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.

View explanations for tiers and restrictions

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.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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