Chelation therapy

Note: If lead poisoning is suspected, consult a clinical toxicologist early for advice on the use of chelation therapy.

If lead poisoning is suspected, consult a clinical toxicologist early for advice on the use of chelation therapy. Chelation therapy may be required for months. Oral chelation therapy is indicated for symptomatic patients or those with high whole blood lead concentrations, even if an ingested lead object has been removed. Most Australian toxicology units stock succimer (dimercaptosuccinic acid [DMSA]) for oral chelation therapy. Parenteral chelation therapy is indicated for patients with lead encephalopathy.

None of the chelating agents discussed below are registered for use in Australia and all have limited availability through the Special access scheme. Treatment may be determined by which agent can be obtained in a timely fashion.

Regardless of whether chelation therapy is indicated, consideration of removal of an ingested lead object, and prevention of further exposure to the lead source is of utmost importance.