Edetate calcium disodium
CALCIUM DISODIUM VERSENATE
What it isCalcium disodium EDTA; lead poisoning.
Why this oneChelates lead without stripping calcium, which the disodium salt fatally does.
What limits it⚑ Disodium EDTA given by mistake causes fatal hypocalcemia — the names are dangerously similar. Nephrotoxic; it can redistribute lead to the brain without BAL.
Principal riskThe DISODIUM salt is fatal — the names are similar
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityNephrotoxicity and worsening lead encephalopathy
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Lead poisoning (blood lead >20 to <70 mcg/dL, asymptomatic) | Adults & pediatrics | 1,000 mg/m2/day | 1,000 mg/m2/day | 1,000 mg/m2/day (do not exceed) |
| Lead nephropathy | Adults | 500 mg/m2 q24h x5 days (SCr 2-3 mg/dL); q48h x3 (SCr 3-4); weekly (SCr >4) | — | per creatinine-based schedule |
Renal Reduce dose in pre-existing renal impairment; contraindicated in anuria/active renal disease
Hepatic Contraindicated in hepatitis
Do not exceed recommended daily dose; use with BAL when blood lead >70 mcg/dL or symptomatic
Instructions
- IM preferred for overt lead encephalopathy; add lidocaine/procaine to reduce injection pain
- IV: dilute daily dose in 250-500 mL D5W or 0.9% NaCl and infuse over 8-12 hours
- Establish urine flow before first dose; stop if urine flow ceases
- 5-day course, then interrupt 2-4 days; usually two courses
Available strengths
- inj 200 mg/mL
Contraindications
- Anuria
- Active renal disease
- Hepatitis
Cautions
- Potentially fatal toxicity
- Lead encephalopathy/increased intracranial pressure (prefer IM; avoid rapid IV)
- Acute renal tubular necrosis
- Zinc and essential metal depletion
- Follow dosing schedule strictly
Adverse reactions
- Injection-site pain
- Fever/chills/malaise
- Renal tubular necrosis, proteinuria, hematuria
- Hypotension, cardiac rhythm irregularities
- Nausea/vomiting/anorexia
- Mild transaminase elevations
- Zinc deficiency, hypercalcemia
- Transient bone marrow depression/anemia
Pregnancy Use during pregnancy only if clearly needed; animal fetal malformations (prevented by dietary zinc).
Lactation Undefined
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Self-check
- Which EDTA substitution can cause fatal hypocalcemia?
Disodium EDTA instead of calcium disodium EDTA. - Which renal toxicity limits calcium disodium EDTA?
Nephrotoxicity.