Succimer Disease Interactions

Succimer is primarily eliminated by the kidney. Therapy with succimer should be administered after dehydration is corrected and urine output sufficient for the elimination of succimer.

Succimer undergoes extensive metabolism by the liver. Therapy with succimer should be administered cautiously in patients with liver disease.

Mild to moderate neutropenia has been observed in some patients receiving succimer. A complete blood count with white blood cell differential and direct platelet counts should be obtained prior to and weekly during treatment. Therapy should either be withheld or discontinued if the absolute neutrophil count (ANC) is below 1200/mcL and the patient followed closely to document recovery of the ANC to above 1500/mcL or to the patient's baseline neutrophil count. There is limited experience with reexposure in patients who have developed neutropenia. Therefore, such patients should be rechallenged only if the benefit of therapy clearly outweighs the potential risk of another episode of neutropenia and then only with careful patient monitoring.

Succimer is primarily eliminated by the kidney complexed with a heavy metal (lead, arsenic, mercury). Therapy with succimer should be administered cautiously in patients with renal impairment. Succimer should be discontinued if acute renal failure develops. Clinical monitoring of renal function is necessary. However, succimer has been used with some success in combination with extracorporeal regional complexing hemodialysis in patients with renal failure.