ジメルカプロール
Dimercaprol
2,3-dimercapto-1-propanol
別名: BAL in Oil · Sulfactin Homburg · British anti-lewisite · dimercaptopropanol · dithioglycerol dimercaprolum · Dicaptol
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
豚
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ジメルカプロール（別名BALまたは英国抗ルイサイト剤）は、獣医学において主にヒ素中毒の治療に使用される重金属キレート剤です。鉛、水銀、金の中毒にも使用されることがあります。
第二次世界大戦中にルイサイト（ヒ素系化学兵器）の解毒剤として開発されました。重金属と結合するスルフヒドリル基を含み、必須細胞酵素の阻害を防ぎます。
臨床上のポイント： ピーナッツオイルに溶解されており、深部筋肉内注射で投与する必要がありますが、強い痛みを伴います。セレンなどの一部の金属には効果が薄く、鉄、カドミウム、セレン中毒には絶対禁忌です（形成される複合体が金属単体よりも強い毒性を持つため）。
作用機序
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.
安全性・警告
禁忌
- Impaired hepatic function (unless secondary to acute arsenic toxicity)
- Iron poisoning
- Cadmium poisoning
- Selenium poisoning
有害事象
- Pain at injection site
- Vomiting
- Seizures (at higher dosages)
- Transient increases in blood pressure
- Tachycardia
- Nephrotoxicity
注意事項
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.
医薬品相互作用
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
監視
- Liver function
- Renal function
- Hemogram
- Hydration and perfusion status
- Electrolytes and acid/base status
- Urinary pH (maintain alkaline pH)
薬物動態
吸収
Peak blood levels occur in 30-60 minutes after IM injection. Slowly absorbed through the skin after topical administration.
分布
Distributed throughout the body, including the brain. Highest tissue levels are found in the liver and kidneys.
代謝
Non-metal bound drug is rapidly metabolized to inactive compounds.
消失
Excreted in the urine, bile, and feces. In humans, completely eliminated within 6-24 hours.
過剰投与
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.
製品
製剤
- Injection: 100 mg/mL (10%) in peanut oil and benzyl benzoate
ヒト用医薬品
- Dimercaprol Injection: 100 mg/mL (10%) (for IM use only) in 3 mL ampules (BAL in Oil)
規制ステータス
POM status.
POM (Prescription Only Medicine).
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
- 厳密な管理が必要：この薬には潜在的な毒性があり、重金属中毒は命に関わるため、通常は入院環境で獣医師の厳密な監督の下で使用する必要があります。
- 特有の臭い：ペットの息からニンニクやスカンクのような強い不快な臭い（メルカプタン臭）がすることがありますが、これは薬の正常な影響です。
- 注射の痛み：筋肉の深部に注射するため、ペットにとって強い痛みを伴うことがあります。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。