Bradberry S, Vale A.1 Dimercaptosuccinic acid (succimer; DMSA) in inorganic lead poisoning. Clin Toxicol (Phila). 2009 Aug;47(7):617-31.
1 West Midlands Poisons Unit, City Hospital, Birmingham, UK.
INTRODUCTION: This article reviews data on the efficacy of succimer
(dimercaptosuccinic acid, DMSA) in the treatment of human inorganic lead
poisoning, the adverse effects associated with its use, and summarizes current
understanding of the pharmacokinetic and pharmacodynamic aspects.
CONCLUSIONS: DMSA is an effective lead chelator that primarily chelates renal
lead. It is generally well tolerated but may occasionally cause clinically
important adverse effects. DMSA may now be considered as an alternative to sodium calcium edetate, particularly when an oral antidote is preferable.
The bioavailability or oral DMSA is 20 to 50%.[i]
Pregnant or lactating women and patients with kidney disorders should not be chelated. In case of an acute intoxication, chelation should only be administered after careful medical evaluation and consideration. Be careful with highly allergic patients, especially those allergic to sulfur.