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ethylenediamine tetra-acetic acid (EDTA, Endrate, calcium disodium versenate, edetic acid, edetate)

Tradename: Calcium disodium versenate (edetate) *** DISTINGUISH edetate disodium from edetate calcium disodium *** Withdrawn from US Market 2008 due to safety concerns: 1) inappropriate off-label use 2) name confusion with edetate calcium disodium) Indications: - lead poisoning - may be useful for poisonings due to radioactive & nuclear fission products - hypercalcemia [6] Contraindications: - mercury poisoning - gold toxicity - arsenic poisoning Dosage: - 2 g/day or 1.5 g/m2/day divided every 12-24 hours for 5 days Injection: 200 mg/mL (5 mL). Pharmacokinetics: 1) well-absorbed after IM or SC administration 2) excretion begin 1 hour after IV administration 3) peak excretion is seen in 24-48 hours 4) most is excreted in the urine within 24 hours 5) does not penetrate CSF 6) 1/2life is 30-90 minutes 7) accumulation is noted with renal dysfunction Adverse effects: 1) renal/urinary tract a) nephrosis/renal tubular necrosis (may be fatal) b) hematuria c) proteinuria 2) tremors 3) uncommon (< 1%) - hypotension, nasal congestion, arrhythmias, paresthesias, fever, headache, rash, hypercalcemia, nausea/vomiting, phlebitis, sneezing, lacrimation, transient bone marrow suppression 4) deaths reported when edetate disodium given, rather than intended edetate calcium disodium [5] due to hypocalcemia ? (edetate disodium is FDA approved as an emergency treatment for certain patients with hypercalcemia) Mechanism of action: 1) chelating agents for iron & other heavy metals 2) 1 g of calcium EDTA sequesters 620 mg of lead 3) EDTA complexes are eliminated in the urine

General

amine chelating agent

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1168
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Department of Veterans Affairs, VA National Formulary
  5. FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#Edetate
  6. Deprecated Reference