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DMSA
Overview
What is DMSA?
Each vial contains a sterile, pyrogen-free freeze-dried mixture of 1.0 mg dimercaptosuccinic acid, 0.42 mg stannous chloride dihydrate [0.38 mg (minimum) stannous chloride dihydrate (SnCl•2HO) and 0.46 mg (maximum) total tin expressed as stannous chloride dihydrate (SnCl•2HO)], 0.70 mg ascorbic acid, and 50.0 mg inositol. After freeze-drying, vials are sealed under a nitrogen atmosphere with a rubber closure. Sodium hydroxide and hydrochloric acid have been used for pH adjustment. When sterile, oxidant-free, pyrogen-free sodium pertechnetate Tc99m injection in isotonic saline is combined with the vial contents, following the instructions provided with the kit, a complex is formed. After 10 minutes incubation the reconstituted solution is ready for intravenous injection.
Chemical Name: meso-2,3-dimercaptosuccinic acid
The succimer component of DMSA consists of more than 90% meso isomer and less than 10% d,l isomer.
What does DMSA look like?
What are the available doses of DMSA?
Sorry No records found.
What should I talk to my health care provider before I take DMSA?
Sorry No records found
How should I use DMSA?
DMSA is to be used as an aid in the scintigraphic evaluation of renal parenchymal disorders.
The suggested dose range for slow I.V. administration to be employed in the average patient (70 kg) for renal parenchymal imaging is 74-222 MBq, 2-6 mCi technetium Tc99m succimer injection.
The product must be used between 10 minutes to 4 hours following preparation (see "" section). Acceptable renal images may be obtained beginning 1 to 2 hours post injection. Any unused portion should be discarded after that time.
The patient dose should be measured by a suitable radioactivity calibration system immediately prior to administration.
Do not use after the expiration date stated on the label. The components of the kit are supplied sterile and pyrogen-free. Aseptic procedures normally employed in making additions and withdrawals from sterile, pyrogen-free containers should be used during addition of sodium pertechnetate Tc99m injection solutions and during the withdrawal of doses for patient administration.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.
What interacts with DMSA?
None known.
What are the warnings of DMSA?
If spinal cord compression or renal impairment develops, standard treatment of these complications should be instituted.
What are the precautions of DMSA?
General
As in the use of any radioactive material, care should be taken to minimize radiation exposure to the patient consistent with proper patient management and to ensure minimum radiation exposure to occupational workers.
DMSA should be used between 10 minutes and 4 hours following reconstitution (see "" section). Any unused portion should be discarded after that time.
Some patients with advanced renal failure may exhibit poor renal intake of Tc99m DMSA. It has been reported that satisfactory images may be obtained in some of these patients by delaying imaging for up to 24 hours.
The contents of the kit vials are intended only for use in the preparation of DMSA Injection and are not to be directly administered to the patient.
The contents of the kit vials are not radioactive. However, after Tc99m is added, adequate shielding of the final preparation must be maintained.
Radiopharmaceuticals should be used only by physicians who are qualified by training and experience in the safe use and handling of radionuclides and whose experience and training have been approved by the appropriate government agency authorized to license the use of radionuclides.
Carcinogenesis, Mutagenesis, Impairment of Fertility
No long term animal studies have been performed to evaluate carcinogenic potential, mutagenic potential, or whether technetium Tc99m succimer injection affects fertility in males or females.
Pregnancy Category C
Animal reproduction studies have not been conducted with technetium Tc99m succimer injection. It is also not known whether technetium Tc99m succimer injection can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Technetium Tc99m succimer injection should be administered to a pregnant woman only if clearly needed.
Ideally, examinations using radiopharmaceuticals, especially those elective in nature, of a woman of child bearing capability should be performed during the first few (approximately 10) days following the onset of menses.
Nursing Mothers
Technetium Tc99m is excreted in human milk during lactation; therefore, formula feedings should be substituted for breast feedings.
Pediatric Use
Safety and effectiveness in pedriatric patients have not been established
Geriatric Use
Clinical studies of DMSA did not include sufficient numbers of subjects age 65 and over to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
What are the side effects of DMSA?
Rare instances of syncope, fever, nausea and maculopapular skin rash have been reported.
What should I look out for while using DMSA?
None known.
None.
What might happen if I take too much DMSA?
Sorry No Records found
How should I store and handle DMSA?
Store the kit at 2°-8°C (36°-46°F) and protect from light.ArrayStore the kit at 2°-8°C (36°-46°F) and protect from light.ArrayKit ContentsNDC 017156-525-01Kit ContentsNDC 017156-525-01
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
After intravenous administration, technetium Tc99m succimer injection is distributed in the plasma, apparently bound to plasma proteins. There is negligible activity in the red blood cells. The activity is cleared from the plasma with a half-time of about 60 minutes and concentrates in the renal cortex. Approximately 16% of the activity is excreted in the urine within two hours. At six hours about 20% of the dose is concentrated in each kidney.
Non-Clinical Toxicology
None known.None.
See .
As in the use of any radioactive material, care should be taken to minimize radiation exposure to the patient consistent with proper patient management and to ensure minimum radiation exposure to occupational workers.
DMSA should be used between 10 minutes and 4 hours following reconstitution (see "" section). Any unused portion should be discarded after that time.
Some patients with advanced renal failure may exhibit poor renal intake of Tc99m DMSA. It has been reported that satisfactory images may be obtained in some of these patients by delaying imaging for up to 24 hours.
The contents of the kit vials are intended only for use in the preparation of DMSA Injection and are not to be directly administered to the patient.
The contents of the kit vials are not radioactive. However, after Tc99m is added, adequate shielding of the final preparation must be maintained.
Radiopharmaceuticals should be used only by physicians who are qualified by training and experience in the safe use and handling of radionuclides and whose experience and training have been approved by the appropriate government agency authorized to license the use of radionuclides.
Rare instances of syncope, fever, nausea and maculopapular skin rash have been reported.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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