Dimercaprol Injection

What is Dimercaprol Injection?
Dimercaprol Injection is a specialized chelating agent developed during World War II as an antidote for the arsenic-based chemical weapon Lewisite. Today, it remains a critical emergency medication for the treatment of acute poisoning by arsenic, gold, and mercury. Because it is insoluble in water, it is formulated in a base of peanut oil, making it a deep intramuscular treatment used to scavenge toxic metal ions from the body's tissues.
Uses of Dimercaprol Injection
Arsenic Poisoning: Management of acute toxicity from inorganic arsenic compounds.
Mercury Poisoning: Treatment of acute mercury toxicity (administered within hours of ingestion for best results).
Gold Toxicity: Used to treat severe adverse reactions to gold therapy (chrysotherapy).
Lead Poisoning: Used as an adjunct to Edetate Calcium Disodium (CaNa₂EDTA) in the treatment of severe lead encephalopathy.
Wilson’s Disease: Occasionally used as a second-line agent to manage copper accumulation when other oral chelators are not tolerated.
How Does Dimercaprol Injection Work?
Dimercaprol works through a process called chelation. Many heavy metals exert their toxic effects by binding to the "sulfhydryl groups" of essential cellular enzymes, shutting down metabolism. Dimercaprol contains two highly reactive sulfhydryl (-SH) groups that compete with these enzymes for the metal. It physically "grabs" the metal ion, forming a stable, non-toxic five-membered ring complex that is water-soluble and can be safely excreted by the kidneys.
FAQs on Dimercaprol Injection
1. Why is Dimercaprol formulated in peanut oil? Dimercaprol is highly unstable in water and is an oily liquid itself. The peanut oil base provides a stable medium for the drug and allows for a slow, controlled release into the systemic circulation after a deep muscle injection. Note: It must not be used in patients with a known peanut allergy.
2. How is the injection administered? It is administered strictly via deep intramuscular (IM) injection into the gluteal muscle. It should never be given intravenously. Because the injection can be painful and the treatment course involves multiple doses, the injection sites are usually rotated.
3. What are common side effects during treatment? Patients often experience a temporary rise in blood pressure and heart rate (tachycardia) shortly after injection. Other common symptoms include a "burning sensation" in the mouth, throat, or eyes, nausea, and a distinct garlic-like odor on the breath.
Therapeutic Category
Others (Antidote / Chelating Agent)
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