Edetate Disodium (EDTA)
( EDTA ) Pronouncation: (EH-duh-tate die-SO-dee-uhm)
Class: Cardiovascular agent
Trade Names:
Endrate
- Injection 150 mg/mL
Mechanism of Action
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.
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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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