Chemet Dosage

Generic name: SUCCIMER 100mg
Dosage form: capsule
Drug class: Chelating agents

Medically reviewed by Drugs.com. Last updated on Sep 24, 2024.

Important Pretreatment Evaluations

Identify the source of lead in the pediatric patient's environment and eliminate the source prior to beginning treatment with CHEMET.
Assess the following before initiating treatment with CHEMET:
- Blood lead concentration
- Complete blood count (CBC) with differential and platelets
- Ensure absolute neutrophil count (ANC) > 1500/mcL
- Transaminases (AST/ALT)
- Renal function with blood urea nitrogen (BUN), creatinine, urinary protein.
Patients who have previously received Edetate calcium disodium (CaNa2EDTA) with or without dimercaprol may receive CHEMET for subsequent treatment after an interval of four weeks.

Recommended Dosage

The recommended dosage of CHEMET for pediatric patients with lead poisoning is 10 mg/kg or 350 mg/m2 orally every 8 hours for five days followed by 10 mg/kg or 350 mg/m2 orally every 12 hours for an additional 14 days. Initiation of therapy at higher doses is not recommended. The total treatment course consists of 19 days.

After discontinuation of CHEMET, elevated blood levels and associated symptoms may return rapidly because of redistribution of lead from bone stores to soft tissues and blood. Assess blood lead concentration after the completion of a 19 day course and every week until stable. Repeated courses may be administered after two weeks off treatment if blood lead concentrations remain elevated. A minimum of two weeks between treatment courses is recommended unless blood lead concentrations indicate the need for more prompt treatment.

Table 1. CHEMET Pediatric Dosing Chart
Weight in Kilograms (kg)	Dose (mg)	Number of Capsules
8 to15 kg	100 mg	1
16 to 23 kg	200 mg	2
24 to 34 kg	300 mg	3
35 to 44 kg	400 mg	4
>45 kg	500 mg	5

The safety of uninterrupted dosing longer than 3 weeks has not been established and is not recommended.

Dosage Modifications for Neutropenia

Monitor CBCs weekly.

If the absolute neutrophil count (ANC) is <1200/mcL interrupt CHEMET.

Resume CHEMET when ANC has recovered to >1500/mcL (or the patient's baseline count).
Immediately discontinue CHEMET for signs/symptoms of infection.
Only rechallenge patients who developed neutropenia with CHEMET therapy if the benefit clearly outweighs the potential risk.

Preparation and Administration Instructions

Administer CHEMET capsules whole.

In pediatric patients who cannot swallow the capsules whole, separate the capsule and sprinkle the medicated beads on a small amount of soft food or put them in a spoon and follow with a fruit drink.

Ensure that all patients receiving CHEMET are adequately hydrated.