Parenteral Manual

Calcium disodium edetate

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
CALCIUM EDTA, EDETATE CALCIUM DISODIUM
Classification: 
Heavy metal chelating agent
Original Date: 
August 2005
Revised Date: 
November 2011
Indications: 
  • Adjunct in treatment of acute and chronic lead poisoning
Reconstitution and Stability: 
  • Kept in Poison Control Centre
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

- Incompatible: D10W, lactated ringer's

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES, PREFERRED ROUTE FOR LEAD ENCEPHALOPATHY
Usual dilution: add 1 mL of procaine 1% or lidocaine 1% to each mL of calcium EDTA to minimize pain at injection site)
IV Direct NO
IV Intermittent Infusion

NO

IV Continuous Infusion

YES
Usual dilution: 2-4 mg/mL
Infusion time: >6 hours, up to 24 hours

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Treatment of lead poisoning: (General)     

  • 50-75 mg/kg/day IV or 1000 mg/m2/day IV given over >6 hours depending on volume infused
  • IM: 167-250 mg/m2 Q 4 hours
  • Treatment is usually for 5 days
  • Treatment dose and duration are dependant on symptoms and blood lead level
  • Poison control should be involved in determining dose and duration of therapy
Potential hazards of parenteral administration: 
  • Thrombophlebitis from IV infusion (when concentration >5 mg/mL)
  • Nephrotoxicity
  • Pain at injection site following IM injection
  • GI upset:  nausea, vomiting, diarrhea
  • Hypotension, arrhythmias
  • If extravasation occurs, click HERE for treatment guidelines. 
Notes: 
  • Adequate hydration must be monitored during therapy
  • If anuria, increasing proteinuria or hematuria occurs, discontinue therapy
  • Adjust dosage in patients with renal impairment
  • Monitor BUN, creatinine, urinalysis, fluid balance, EKG, blood and urine lead concentrations, blood pressure
  • Will also decrease iron levels, monitor or replace if stores are questionable
  • Avoid rapid IV infusion in the management of lead encephalopathy, intracranial pressure may be increased to lethal levels.  IM administration is the preferred route in these patients.
  • EDTA infusion should be stopped for 1 hour before drawing blood lead level.

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