Dimercaprol
2,3-dimercapto-1-propanol
También conocido como: BAL in Oil · Sulfactin Homburg · British anti-lewisite · dimercaptopropanol · dithioglycerol dimercaprolum · Dicaptol
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate: 40-50 mg/kg IV as a 20% solution 2-3 times daily.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days, then q12h | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate.
- Arsenic toxicity: If ingestion was within 36 hours. Use emetics/gastric lavage if recent. Institute fluid therapy.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | 2 or more additional days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | Next 48 hours | 🌎 NA |
- Arsenic toxicity: Therapy is difficult due to large volumes required and painful IM route. Must be used acutely; delays significantly decrease effectiveness.
- Arsenic toxicity: Effective if administered within hours of ingestion. Wash off topical arsenic, empty digestive tract. Administer sodium thiosulfate PO and IV.
Ganado
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Arsenic toxicity (no clinical signs) | 3 mg/kg IM | IM | q8h | — | 🌎 NA |
| Arsenic toxicity (clinical signs) | 6 mg/kg IM | IM | q8h | 3-5 days | 🌎 NA |
| Arsenic, lead or mercury poisoning | 2.5-5 mg/kg IM | IM | q4h | 2 days | 🌎 NA |
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Arsenic, lead or mercury poisoning: Efficacy questionable unless given before signs appear or very early. Withdrawal info not available.
- Mercury toxicity: Treatment is often unsuccessful.
Cerdos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Mercury toxicity: Treatment is often unsuccessful.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El dimercaprol (también conocido como British Anti-Lewisite o BAL) es un agente quelante de metales pesados utilizado principalmente en medicina veterinaria para tratar la toxicidad por arsénico. También se utiliza ocasionalmente para intoxicaciones por plomo, mercurio y oro.
Desarrollado originalmente durante la Segunda Guerra Mundial como antídoto para la Lewisite (un agente de guerra química a base de arsénico), contiene grupos sulfhidrilo que se unen a los metales pesados, evitando que interfieran con las enzimas celulares esenciales.
Perla clínica: El dimercaprol está formulado en aceite de cacahuete y debe administrarse mediante inyección intramuscular profunda, lo cual puede ser bastante doloroso. Es relativamente ineficaz para ciertos metales como el selenio y está estrictamente contraindicado en casos de envenenamiento por hierro, cadmio y selenio, ya que el complejo dimercaprol-metal resultante es más tóxico que el metal por sí solo.
Mecanismo de acción
Heavy metals exert their toxic effects by binding to sulfhydryl (-SH) groups on essential cellular enzymes, leading to enzyme inactivation. Dimercaprol contains two sulfhydryl groups that act as "decoys."
- Dimercaprol + Heavy Metal → Heterocyclic Ring Complex
- This complex is more stable than the metal-enzyme bond, allowing the metal to be pulled away from the tissues and excreted via the kidneys and feces.
Mechanistic Note: The chelation is not irreversible. The complex can dissociate as dimercaprol concentrations decrease, if oxidized, or in an acidic environment. Therefore, alkalinizing the urine is crucial to prevent the complex from dissociating in the kidneys and causing nephrotoxicity.
Seguridad y advertencias
Contraindicaciones
- Impaired hepatic function (unless secondary to acute arsenic toxicity)
- Iron poisoning
- Cadmium poisoning
- Selenium poisoning
Efectos adversos
- Pain at injection site
- Vomiting
- Seizures (at higher dosages)
- Transient increases in blood pressure
- Tachycardia
- Nephrotoxicity
Precauciones
Dimercaprol is potentially nephrotoxic; use cautiously in patients with impaired renal function. To protect the kidneys, the urine should be alkalinized to prevent the chelated drug from dissociating in the urine. Animals with diminished renal function or who develop renal dysfunction while on therapy should have the dosage adjusted or therapy discontinued. IM injections must be administered deeply to minimize pain. May decrease Iodine I 131 thyroidal uptake values.
Interacciones farmacológicas
Forms a highly toxic complex. Do not administer with iron salts; wait at least 24 hours after the last dimercaprol dose before starting iron therapy.
Forms a highly toxic complex. Do not administer with selenium salts; wait at least 24 hours after the last dimercaprol dose before starting selenium therapy.
Forms a highly toxic complex.
Forms a highly toxic complex.
Forms highly toxic complexes
Monitorización
- Liver function
- Renal function
- Hemogram
- Hydration and perfusion status
- Electrolytes and acid/base status
- Urinary pH (maintain alkaline pH)
Farmacocinética
Absorción
Peak blood levels occur in 30-60 minutes after IM injection. Slowly absorbed through the skin after topical administration.
Distribución
Distributed throughout the body, including the brain. Highest tissue levels are found in the liver and kidneys.
Metabolismo
Non-metal bound drug is rapidly metabolized to inactive compounds.
Eliminación
Excreted in the urine, bile, and feces. In humans, completely eliminated within 6-24 hours.
Sobredosis
Clinical signs of dimercaprol overdosage in animals include vomiting, seizures, tremors, coma, and death. No specific doses were located to correspond with these clinical signs. Treatment should be supportive and symptomatic.
Productos disponibles
Formulaciones
- Injection: 100 mg/mL (10%) in peanut oil and benzyl benzoate
Etiquetado para humanos
- Dimercaprol Injection: 100 mg/mL (10%) (for IM use only) in 3 mL ampules (BAL in Oil)
Estado regulador
POM status.
POM (Prescription Only Medicine).
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store below 40°C; preferably at room temperature (15-30°C). Unstable in aqueous solutions. The commercially available injection is a peanut oil and benzyl benzoate solution. Turbidity or small amounts of flocculent material/sediment do not indicate deterioration.
Información para el cliente
- Supervisión estricta requerida: Debido al potencial de toxicidad de este agente y a la naturaleza potencialmente mortal de las intoxicaciones por metales pesados, este fármaco debe utilizarse bajo una estrecha supervisión veterinaria profesional, generalmente en un entorno hospitalario.
- Olor inusual: El dimercaprol puede impartir un olor fuerte y desagradable similar al mercaptano (olor a ajo o a mofeta) en el aliento de su animal. Este es un efecto normal del medicamento.
- Dolor en la inyección: El medicamento se administra mediante una inyección intramuscular profunda y puede ser bastante doloroso para su mascota.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.