Nephrotoxicity (eg, acute tubular necrosis, proteinuria, and hematuria) may be minimized by adequate hydration, establishment of adequate urine flow, avoidance of excessive doses, and limitation of continuous administration to 5 days or fewer. Laboratory assessment of renal function should be performed daily during treatment for severe intoxication and after the second and fifth days in other cases.
Black box warning. In individuals with lead encephalopathy, rapid or high-volume infusions may exacerbate increased intracranial pressure. In such cases, it is preferable to use lower volumes of more concentrated solutions for intravenous infusions. Alternatively, intramuscular injection may be considered.
Local pain may occur at intramuscular injection sites. Lidocaine (1 mL of 1% lidocaine per 1 mL of EDTA concentrate) may be added to intramuscular injections to decrease discomfort.
Inadvertent use of sodium EDTA (edetate disodium) may cause serious hypocalcemia.
Calcium EDTA may result in short-term zinc depletion, which has uncertain clinical significance.
Use in pregnancy. The safety of calcium EDTA in human pregnancy has not been established, although uncomplicated use late in pregnancy has been reported. Fetal malformations with high doses have been noted in animal studies, possibly as a consequence of zinc depletion. If severe lead ...