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9/14/2021

Calcium Disodium Versenate Injection

Products Affected - Description

    • Calcium disodium versenate injection, Bausch Health, 200 mg/mL, 5 mL ampule, 5 count, NDC 99207-0240-05

Reason for the Shortage

    • Bausch Health did not provide a reason for the shortage. They are the sole suppliers of calcium disodium versenate injection.[1]

Available Products

    • There are no presentations available

Estimated Resupply Dates

    • Bausch Health has calcium disodium versenate 200 mg/mL 5 mL ampules on back order and the company estimates a release date of November 2021.[1]

Implications for Patient Care

    • Calcium disodium versenate is a chelation therapy used in both pediatric and adult lead poisonings.[2]
    • Calcium disodium versenate may be used as monotherapy; however, it is generally used in combination with dimercaprol (BAL) for more severe poisonings (eg, symptomatic poisoning, lead encephalopathy, blood lead concentrations > 70 mcg/dL).[3-4]

Alternative Agents & Management

    • Information on assessing lead poisonings and initiating chelation therapy can be found at https://www.cdc.gov/nceh/lead/advisory/acclpp/actions-blls.htm
    • During this shortage, consider succimer (DSMA) with or without dimercaprol (BAL).[5] Though dimercaprol (BAL) is rarely used alone, consider dimercaprol (BAL) as monotherapy if succimer is unavailable.[6] Typical dosing for lead poisoning for both agents is listed below.
    • 1. Succimer (DMSA): 10 mg/kg (350 mg/m2) orally every 8 hours for the first 5 days, then every 12 hours for 2 weeks (treatment duration of 19 days and maximum daily dose of 500 mg). Use caution in patients with renal impairment.[7-9]
    • 2. Dimercaprol (BAL): 4 mg/kg deep IM every 4 hours for 2 to 7 days.[10-11]
    • Dosing may vary for different heavy metal poisonings. Contact your local clinical toxicologist or poison control center for patient-specific recommendations.

References

    1. Bausch Health (personal communication): December 28, 2020; January 15, March 12, April 16, May 28, August 6, and September 10, 2021.
    2. Calcium Disodium versenate - edetate calcium disodium injection [package insert]. Scottsdale, AZ: Medicis; 2012.
    3. Edetate Calcium Disodium. Drugdex System. IBM Micromedex [database online]. http://www.micromedexsolutions.com. Updated March 8, 2021. Greenwood Village, CO, USA: Truven Health Analytics; Accessed April 6, 2021.
    4. Howland M. Edetate Calcium Disodium (CaNa2Edta). In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank's Toxicologic Emergencies. 11th ed. McGraw-Hill; Accessed April 6, 2021. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2569§ionid=210263402
    5. Howland M. Dimercaprol (British Anti-Lewisite or BAL). In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank's Toxicologic Emergencies, 11th ed. McGraw-Hill; Accessed April 06, 2021. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2569§ionid=210263297
    6. Flora SJ, Pachauri V. Chelation in metal intoxication. Int J Environ Res Public Health. 2010;7(7):2745-2788. doi:10.3390/ijerph7072745
    7. Succimer. Drugdex System. IBM Micromedex [database online]. http://micromedexsolutions.com. Updated July 27, 2020. Greenwood Village, CO: Truven Health Analytics; Accessed April 6, 2021.
    8. Succimer. Lexicomp Online. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc; 2018. http://online.lexi.com/. Updated March 12, 2021. Accessed April 6, 2021.
    9. Howland M. Succimer (2,3-Dimercaptosuccinic Acid) and Dmps (2,3-Dimercapto-1-Propanesulfonic Acid). In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank's Toxicologic Emergencies, 11th ed. McGraw-Hill; Accessed April 06, 2021. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2569§ionid=210263346
    10. Dimercaprol. Lexicomp Online. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc; 2018. http://online.lexi.com/. Updated March 4, 2021. Accessed April 6, 2021.
    11. Dimercaprol. Drugdex System. IBM Micromedex [database online]. http://www.micromedexsolutions.com. Updated July 20, 2020. Greenwood Village, CO: Truven Health Analytics; Accesed April 6, 2021.

Updated

Updated September 14, 2021 by Michelle Wheeler, PharmD, Drug Information Specialist. Created December 28, 2020 by Michelle Wheeler, PharmD, Drug Information Specialist. © 2021, Drug Information Service, University of Utah, Salt Lake City, UT.

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