Yes

Chelating Agent

Emergency treatment of hypercalcemia; control digitalis-induced cardiac dysrhythmias (ventricular arrhythmias)

C

Severe renal failure or anuria

Use of this drug is recommended only when the severity of the clinical condition justifies the aggressive measures associated with this type of therapy; use with caution in patients with renal dysfunction, intracranial lesions, seizure disorders, coronary or peripheral vascular disease

Rapid I.V. administration or excessive doses may cause a sudden drop in serum calcium concentration which may lead to hypocalcemic tetany, seizures, arrhythmias, and death from respiratory arrest. Do not exceed recommended dosage and rate of administration.

<1%: Arrhythmias, transient hypotension, acute tubular necrosis, seizures, fever, headache, tetany, chills, eruptions, dermatologic lesions, hypomagnesemia, hypokalemia, anemia, thrombophlebitis, pain at the site of injection, paresthesia may occur, back pain, muscle cramps, nephrotoxicity, death from respiratory arrest

Symptoms of overdose include hypotension, dysrhythmias, tetany, seizures

Treatment includes immediate I.V. calcium salts for hypocalcemia related adverse reactions; replace calcium cautiously in patients on digitalis

Increased effect of insulin (edetate disodium may decrease blood glucose concentrations and reduce insulin requirements in diabetic patients treated with insulin)

Chelates with divalent or trivalent metals to form a soluble complex that is then eliminated in urine

Metabolism: Not metabolized

Half-life: 20-60 minutes

Elimination: Following chelation, 95% excreted in urine as chelates within 24-48 hours

Hypercalcemia: I.V.:

Adults: 50 mg/kg/day over 3 or more hours to a maximum of 3 g/24 hours; a suggested regimen of 5 days followed by 2 days without drug and repeated courses up to 15 total doses

Must be diluted before use in 500 mL D₅W or normal saline to <30 mg/mL

Cardiac function (EKG monitoring); blood pressure during infusion; renal function should be assessed before and during therapy; monitor calcium, magnesium, and potassium levels; cardiac monitor required

No information available to require special precautions

No effects or complications reported

Patient education and instruction will be determined by patient condition and ability to understand. You will require frequent blood tests and monitoring during this infusion. You must remain supine during infusion and for a period of time following treatment; change position slowly and ask for assistance if you must get up. Immediately report any difficulty breathing, chest pain, or irregular heartbeat; headache, abdominal cramps, chills, back pain, or muscle rigidity or cramping; or pain at injection/infusion site. Inform prescriber if you are pregnant.

Avoid extravasation; patient should remain supine for a short period after infusion; infuse over 3-4 hours

Injection: 150 mg/mL (20 mL)

MacCara ME, "Extravasation - A Hazard of Intravenous Therapy," Drug Intell Clin Pharm, 1983, 17:713.

Pfister RR, "Chemical Injuries of the Eye," Ophthalmology, 1983, 90(10):1246-53.

"Treatment Guidelines for Lead Exposure in Children. American Academy of Pediatrics Committee on Drugs," Pediatrics, 1995, 96(1 Pt 1):155-60.