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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.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Succimer, also called DMSA, is a heavy metal chelating agent that a pharmacy may compound when a prescriber orders it.
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.
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.
Shake the bottle if your label says to. Measure each dose with the oral syringe or dosing cup the pharmacy gave you, never a kitchen spoon. Give the liquid slowly into the mouth. Rinse the syringe with water after each use. Call the pharmacy if you are unsure how to measure.
Storage depends on the vehicle. Water-based liquids with a preservative usually carry a USP <795> beyond-use date of up to 35 days; without a preservative they are kept refrigerated for up to 14 days. Oil-based (nonaqueous) oral liquids may carry up to 90 days. Your label states whether to refrigerate and the beyond-use date. Keep out of reach of children and discard after that date.
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.
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.
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.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
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.
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.
Take orally
