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Formulas

Dimercaptosuccinic Acid 150 mg/0.5 mL Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Dimercaptosuccinic Acid
For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription detailsOrder form
Controlled substance: e-prescribe (EPCS) from your EHR. Faxed and phoned prescriptions cannot be accepted for this preparation.
Send it from your EHR, or fax to (401) 284-4506. How to e-prescribe this formula
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
To prescribe, you must be a verified prescriber.
To prescribe, you must be in a state where we hold an active out-of-state pharmacy license.
Starting at
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Requires a prescription from your own provider. Bayview is a pharmacy and does not prescribe.
Ships within 1 to 2 business days after pharmacist verification
HSA and FSA eligible
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Get a one-page sheet with everything your doctor needs to prescribe this and send it to Bayview.

Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.

For prescribersSign in for prescription details and order forms.
Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Dimercaptosuccinic Acid
Topical Gel
654e4e57f7b4478a634860bc
Service area

Can we ship this formula to your state?

Bayview fills prescriptions for patients in Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Rhode Island. New York patients are served on a limited basis while nonresident pharmacy registration is pending.

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Available in

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Our current service area

Currently licensed Limited basis, registration pending Not available for this formula Not currently licensed

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Prepared to a prescriber's order for one patient. Not FDA-approved.

This formulation

This is a compounded topical gel containing dimercaptosuccinic acid, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved.

FDA product listings

These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.

FDA-approved products containing succimer (dimercaptosuccinic acid) are listed in capsule and injection forms. No finished succimer (dimercaptosuccinic acid) product of any kind is listed in gel form.

Storage category and dating

Gel bases can be aqueous or nonaqueous, and USP <795> classifies the preparation by its water activity. Aqueous preparations carry shorter default beyond-use dates than nonaqueous ones. The date printed on the label is the one to follow.

Sources

Succimer, also called DMSA, is a heavy metal chelating agent that a pharmacy may compound when a prescriber orders it.

About this ingredient

Succimer, also known as dimercaptosuccinic acid or DMSA, is an oral chelating agent. Its two sulfhydryl groups bind metals such as lead and form water-soluble chelates that the body passes in urine. The manufactured product is Chemet (succimer) capsules, which the FDA label indicates for treatment of lead poisoning in children 1 year and older whose blood lead level is above the threshold stated on the label. The label says Chemet is not for preventing lead poisoning in a lead-containing environment and does not treat lead encephalopathy, because succimer does not cross the blood-brain barrier. Drugs.com reports no FDA-approved generic. A prescriber might order succimer compounded in a strength or oral form that is not manufactured, or in a vehicle free of a specific excipient. Compounded preparations are not FDA-approved and require a prescription.

Safety and interactions

Chemet has no boxed warning. Its label lists allergic and skin reactions, including blistering eruptions of the mouth and other mucous membranes that can worsen with repeat courses; neutropenia; and raised liver enzymes. Blood counts and liver tests are checked during treatment; report fever, chills or other signs of infection right away. Do not take it after an allergic reaction to succimer. The label advises against combining it with other chelating agents such as edetate calcium disodium, and it can cause false urine ketone and falsely low uric acid and CPK results. Based on animal studies it may cause fetal harm, and the label advises contraception during treatment and for 14 days after. There are no data on succimer in breast milk, and the label advises against starting breastfeeding while maternal blood lead is above a stated level. If side effects occur, talk to your prescriber or pharmacist.

Succimer is a dithiol chelator that forms water-soluble lead chelates and increases urinary lead excretion; in label studies it had no significant effect on urinary iron, calcium or magnesium, while zinc excretion doubled. Peak plasma concentrations occur at 1 to 2 hours. About 90 percent of absorbed drug is metabolized to mixed succimer-cysteine disulfides, and the apparent elimination half-life of radiolabeled material in blood was about two days. Chemet (Recordati Rare Diseases) is indicated for pediatric lead poisoning above the labeled blood lead threshold, not for prophylaxis or lead encephalopathy. AHFS describes off-label use for adult lead poisoning and for arsenic and mercury poisoning, with an FDA orphan designation for mercury poisoning; these are not FDA-approved indications. Before starting, the label calls for identifying and removing the lead source and checking blood lead, CBC with differential, transaminases and renal function. Monitor CBC and transaminases at least weekly, interrupt for neutropenia below the labeled threshold, keep the patient hydrated, and recheck blood lead after each course because levels can rebound from bone stores. Dosing is per prescriber. Succimer is not a controlled substance.

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Using and storing

How it is used

Wash your hands. Apply the amount on your label to clean, dry skin and spread it in a thin layer. For a metered pump, your label states the number of presses. For a dosing syringe, push the plunger to the mark. Let the gel dry before covering with clothing. Wash your hands afterward and keep the site from touching other people until it has dried. Do not apply to broken skin unless told to.

Storing it

A gel can have a nonaqueous or a water-based base, and USP <795> sets its default beyond-use date by water content, not by the word gel. A nonaqueous gel usually carries a beyond-use date of up to 180 days at room temperature or refrigerated. A water-based gel carries up to 35 days with a preservative, or 14 days refrigerated without one. Your label states which applies. Keep the container closed, away from heat and open flame if it contains alcohol, out of reach of children, and discard after the beyond-use date on your label.

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Prescribing and ordering FAQs

Formula Information

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Drug Interactions

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Frequently Asked Questions

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About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.

Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Dimercaptosuccinic Acid 150 mg/0.5 mL Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)

Twice daily