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Edetate Disodium

( EDTA ) Pronouncation: (EH-duh-tate die-SO-dee-uhm)
Class: Cardiovascular agent

Trade Names:
Endrate
- Injection 150 mg/mL

Pharmacology

Forms chelates with polyvalent metals, especially calcium, thus increasing their urinary excretion.

Pharmacokinetics

Elimination

The chelate formed is excreted in the urine.

Indications and Usage

Emergency treatment of hypercalcemia; control of ventricular arrhythmias associated with digitalis toxicity.

Contraindications

Anuria.

Dosage and Administration

Adults

IV 50 mg/kg/day (max 3 g/day). Usually administered in 5 consecutive daily doses followed by 2 days without medication, with repeated courses as needed, for total of 15 doses.

Dissolve 50 mg/kg dose in 500 mL of D5W or sodium chloride 0.9% for injection. Infuse over 3 h or more.

Children

IV 40 mg/kg/day (max 70 mg/kg/day) or 15 to 50 mg/kg/day (max 3 g/day) with 5 days between courses.

Dissolve drug in sufficient volume of D5W or sodium chloride 0.9% for injection to bring final concentration to 3% or less. Infuse over 3 h or more.

General Advice

Do not confuse edetate disodium with edetate calcium disodium.

Storage/Stability

Store at room temperature.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Transient drop in BP; adverse reactions on myocardial contractility; thrombophlebitis.

CNS

Transient circumoral paresthesia; numbness; headache.

Dermatologic

Exfoliative dermatitis; toxic skin and mucous membrane reactions.

GI

Nausea; vomiting; diarrhea.

Genitourinary

Nephrotoxicity; damage to reticuloendothelial system.

Hematologic

Thrombophlebitis; anemia.

Metabolic

Electrolyte imbalances including hypocalcemia, hypokalemia, and hypomagnesemia; hyperuricemia.

Miscellaneous

Febrile reactions.

Precautions

Monitor

Hypocalcemia

If signs or symptoms of hypocalcemia occur (eg, circumoral numbness/tingling, positive Chvostek's or Trousseau's signs, tetany), notify health care provider.


Pregnancy

Category C .

Lactation

Undetermined.

Special Risk Patients

Use drug cautiously in patients with limited cardiac reserve or incipient congestive failure.

Diabetic patients

Blood sugar and insulin requirements may be lower in insulin-dependent diabetic patients.

Hydration

Adequately hydrate patient before administration.

IV infusion

Rapid IV infusion or high serum concentrations can cause a precipitous and potentially fatal drop in serum calcium. Do not exceed maximum dose or rate.

Overdosage

Symptoms

Drop in serum calcium.

Patient Information

  • Advise patient to remain recumbent for 30 min after infusion because of possibility of orthostatic hypotension.
  • Inform patient that breath may be odorous.
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