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|Chemet

SUCCIMER (Systemic)†

Some commonly used brand names are:

In the U.S.—

• Chemet

Other commonly used names are dimercaptosuccinic acid and DMSA .

† Not commercially available in Canada.

Category

• Chelating agent

Description

Succimer (SUKS-si-mer) is used in the treatment of acute lead poisoning to remove excess lead from the body, especially in small children.

Succimer combines with lead in the blood stream. The combination of lead and succimer is then removed from the body by the kidneys. By removing the excess lead, the medicine lessens damage to various organs and tissues of the body.

• Oral
• Capsules (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For succimer, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to succimer. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Succimer has not been studied in pregnant women. However, some studies in animals have shown that succimer causes birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—It is not known whether succimer passes into breast milk. However, breast-feeding is not recommended while taking succimer.

Children—This medicine has been tested in children over the age of 1 year and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of succimer in the elderly with use in other age groups.

Other medical problems—The presence of other medical problems may affect the use of succimer. Make sure you tell your doctor if you have any other medical problems, especially:

• Dehydration—Before and while taking succimer, you must drink plenty of fluids and urinate regularly

• Kidney disease—The combination of lead and succimer may not be removed from the body as quickly as it normally would
• Liver disease—This condition may be made worse; your doctor should perform liver function tests regularly while you are taking succimer

Proper Use of This Medicine

Children who have too much lead in their bodies should be removed from the lead-containing environment (for example, home, school, or other areas where the child has been exposed to lead) until the lead has been removed from the environment. If this is not possible, the environment should be made as safe as possible for the child.

Your doctor may want to put your child in the hospital while he or she is receiving succimer. This will allow the doctor to check your child"s condition while the lead can be removed from the child"s environment.

When opening your bottle of succimer, you may notice an unpleasant odor. However, this is a normal odor for these capsules and does not affect how the medicine works.

If the capsules cannot be swallowed, the contents of the capsule may be sprinkled on food and eaten immediately. The contents may also be given on a spoon and followed by a fruit drink.

It is important to drink plenty of fluids while taking succimer .

Dosing—The dose of succimer will be different for different patients. Follow your doctor"s orders or the directions on the label .

• For the oral dosage form (capsules):
  • For treatment of lead poisoning:
    • For adults and children 12 years of age or older—Dose is based on body weight. The usual dose is 10 milligrams (mg) of succimer per kilogram (kg) (4.5 mg per pound) of body weight every eight hours for five days.
    • For children 1 to 11 years of age—Dose is based on body weight. The usual dose is 10 mg of succimer per kg (4.5 mg per pound) of body weight every eight hours for five days. The same dose is then given every twelve hours for the next fourteen days, for a total of nineteen days of therapy.
    • For children up to 1 year of age—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to prevent unwanted effects. Certain blood and urine tests must be done regularly to determine how long you need to take succimer.

If you think you are getting an infection or if you get a fever or chills, contact your doctor as soon as possible. You will need certain tests. Based on the results of the tests, your doctor may advise you to temporarily stop taking succimer to prevent serious side effects from occurring.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if either of the following side effects occurs:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Succimer may cause your urine, sweat, and feces to have an unpleasant odor.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 06/10/1999

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