에데트산 칼슘 이나트륨
Edetate Calcium Disodium
Calcium Disodium Ethylenediaminetetra-acetate
다른 이름: Calcium Disodium Versenate · Calcium Vitis · Calciumedetat-Heyl · Chelante · Chelintox · Ledclair · CaEDTA · sodium calcium edetate · calcium disodium edathamil · calcium disodium edetate · calcium EDTA · disodium calcium tetracemate · E385
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Lead poisoning | 100 mg/kg SC divided into 4 daily doses in 5% dextrose for 5 days. May require second course of treatment, particularly if blood lead levels >0.10 ppm. Do not exceed 2 g/day and do not treat for more than 5 consecutive days. | SC | divided q6h | 5 days | 🌎 NA |
| Lead poisoning | 25 mg/kg SC four times daily for 5 days. Give as 1% solution in D5W. | SC | q6h | 5 days | 🌎 NA |
| Zinc toxicity | 100 mg/kg divided into four SC doses per day. Dilute in D5W to reduce local irritation at site of injection. | SC | divided q6h | Unknown | 🌎 NA |
| Lead or zinc toxicity | 25 mg/kg | SC | q6h | 2-5 days | 🌍 EU |
- Lead poisoning: Be sure there is no lead in GI tract before using.
- Lead poisoning: Provide a 5-7 day rest period between courses of treatment to minimize potential for nephrotoxicity.
- Zinc toxicity: Monitor serum zinc concentrations and maintain animal's hydration status.
- Lead or zinc toxicity: Dilute to 10 mg/ml in 5% dextrose before use. Total daily dose should not exceed 2 g. Dogs that respond slowly or have an initial blood lead level >4.5 μmol/l may need another 5-day course after a rest period of 5 days.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Lead poisoning | 27.5 mg/kg in 15 mL D5W SC four times daily for 5 days. | SC | q6h | 5 days | 🌎 NA |
| Lead or zinc toxicity | 25 mg/kg | SC | q6h | 2-5 days | 🌍 EU |
- Lead poisoning: Recheck blood lead 2-3 weeks later and repeat therapy if greater than 0.2 ppm.
- Lead or zinc toxicity: Dilute to 10 mg/ml in 5% dextrose before use. Total daily dose should not exceed 2 g.
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Heavy metal toxicity (Chinchillas) | 30 mg/kg SC q12h | SC | q12h | Not specified | 🌎 NA |
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Lead poisoning (Psittacines) | 35 mg/kg IM twice daily for 5-7 days. | IM | q12h | 5-7 days | 🌎 NA |
| Lead poisoning (Raptors/Falcons) | 100 mg/kg q12h for 5-25 consecutive days. (25% CaEDTA given undiluted IM) | IM | q12h | 5-25 days | 🌎 NA |
| Lead or zinc poisoning | 30-35 mg/kg IM q12h x 3-5 days, off 3-5 days, may repeat and/or use another chelator. | IM | q12h | 3-5 days | 🌎 NA |
- Lead poisoning (Psittacines): After initial therapy, may give orally until all lead fragments are dissolved and/or passed from GI tract.
- Lead poisoning (Raptors/Falcons): Treated if blood lead was >65 micrograms/dL for 5 day courses, until blood lead was <20 micrograms/dL.
- Lead or zinc poisoning: Maintain hydration. Do not give orally. Can be used IV short term (48 hrs) at 20-35 mg/kg diluted in saline.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Lead poisoning | 75 mg/kg IV slowly in D5W or saline daily for 4-5 days (may divide daily dose into 2-3 administrations per day). | IV | q24h or divided q8-12h | 4-5 days | 🌎 NA |
- Lead poisoning: Stop therapy for 2 days and repeat for another 4-5 days. Give adequate supportive and nutritional therapy.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Lead poisoning | 110 mg/kg per day in 3-4 divided doses; dilute to 1 gram/mL in D5W; first dose IV, then subcutaneously | IV/SC | divided q6-8h | Not specified | 🌎 NA |
| Lead poisoning | 67 mg/kg slow IV twice daily for 2 days; withhold dose for 2 days and then give again for 2 days. | IV | q12h | 2 days on, 2 days off, 2 days on | 🌎 NA |
| Lead poisoning | 73.3 mg/kg/day slow IV divided 2-3 times a day for 3-5 days. | IV | divided q8-12h | 3-5 days | 🌎 NA |
- Lead poisoning: FARAD recommends a 2 day meat and milk withdrawal time.
- Lead poisoning: Cattle may require 10-14 days to recover and may require several series of treatments.
- Lead poisoning: If additional therapy is required, a 2-day rest period followed by another 5-day treatment regimen is recommended.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
에데트산 칼슘 이나트륨(CaEDTA)은 수의학에서 주로 납 및 아연 중독 치료에 사용되는 중금속 킬레이트제입니다. 소동물의 납 중독 치료에는 경구 투여가 가능하고 신독성이 낮은 숙시머(DMSA)가 점점 더 선호되고 있지만, 대동물 및 조류에서는 여전히 중요한 주사용 해독제입니다.
중요한 임상적 주의사항: 반드시 칼슘 이나트륨(Calcium Disodium) 형태의 EDTA를 사용해야 합니다. 칼슘이 없는 에데트산 이나트륨(Na2EDTA)을 투여하면 환자의 내인성 혈청 칼슘을 강력하게 킬레이트하여 빠르고 치명적인 저칼슘혈증을 유발할 수 있습니다.
CaEDTA는 수용성이 매우 높고 신장 배설에 크게 의존하므로 치료 중 적절한 수분 공급과 신장 기능 모니터링이 필수적입니다.
작용 기전
CaEDTA works via competitive chelation. The calcium ion in the CaEDTA complex has a lower binding affinity than heavy metals. When introduced into the bloodstream, divalent or trivalent heavy metals (such as Pb2+ or Zn2+) displace the calcium:
CaEDTA + Pb2+ → PbEDTA + Ca2+
The resulting heavy metal-EDTA complex is highly stable, water-soluble, and is rapidly excreted by the kidneys into the urine.
- Theoretically, 1 gram of CaEDTA binds 620 mg of lead, but in vivo, only about 5 mg of lead is excreted per gram of drug.
- It effectively chelates lead and zinc, and to a lesser extent cadmium, copper, iron, and manganese.
- It is ineffective for mercury, gold, or arsenic poisoning.
안전성·주의사항
금기사항
- Patients with anuria
- Oral (PO) administration in the presence of lead in the GI tract (enhances absorption)
부작용
- Renal toxicity (renal tubular necrosis)
- Depression (dogs)
- Vomiting
- Diarrhea
- Zinc deficiency (with chronic therapy)
- Pain at IM injection site
주의
Use with extreme caution in patients with diminished renal function; dosage adjustments are required.
In small animals, the SC route is strongly preferred. IV administration has been associated with abrupt increases in CSF pressure and death in human pediatric patients with lead-induced cerebral edema.
Do not administer orally if lead is still present in the GI tract, as it will facilitate systemic absorption of the lead. Remove lead from the GI tract (via emesis, endoscopy, or surgery) prior to starting chelation.
Ensure adequate hydration to protect the kidneys, but avoid overhydration in animals showing clinical signs of cerebral edema.
약물 상호작용
May enhance the renal toxicity of CaEDTA
Concurrent administration will decrease the sustained action of the insulin preparation due to zinc chelation
Increased risk of nephrotoxicity; use with extreme caution
모니터링
- Blood lead or zinc levels (serial monitoring)
- Urine d-ALA
- Renal function tests (BUN, Creatinine)
- Urinalyses (monitor for casts/glucose indicating tubular damage)
- Hydration status
- Serum phosphorus and calcium values
- Periodic cardiac rate/rhythm monitoring
약동학
흡수
Well absorbed after either IM or SC administration.
분포
Distributed primarily in the extracellular fluid. Does not penetrate erythrocytes or enter the CNS in appreciable amounts.
대사
Not significantly metabolized.
배설
Rapidly excreted renally, either as unchanged drug or chelated with metals. Changes in urine pH or flow do not significantly alter excretion rate.
과다투여
Doses greater than 12 g/kg are lethal in dogs. Acute toxicity primarily manifests as severe renal tubular necrosis. It can also cause profound depression, vomiting, and diarrhea. Treatment of overdose is largely supportive, focusing on maintaining diuresis and managing uremia.
제품
제형
- Injection solution: 200 mg/mL
동물용의약품
- None commercially available in the USA; may be obtained through compounding pharmacies.
인용의약품
- Edetate Calcium Disodium Injection Solution: 200 mg/mL in 5 mL ampules (1 gram/ampule) (Calcium Disodium Versenate)
규제 현황
POM (Prescription Only Medicine)
POM-V
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at temperatures less than 40°C, preferably at room temperature (15-30°C). The injection can be diluted with either normal saline or 5% dextrose.
보호자 정보
중금속 중독(예: 동전, 납 페인트 또는 금속 철물 섭취)은 생명을 위협할 수 있는 심각한 응급 상황입니다.
- 입원 필요: 이 해독제의 잠재적인 독성과 중금속 중독의 심각성 때문에, 반려동물은 전문가의 세심한 모니터링, 주사 및 정맥 수액 치료를 위해 입원해야 할 가능성이 높습니다.
- 신장 보호: 이 약물은 금속과 결합하여 소변을 통해 배출되도록 합니다. 신장을 씻어내고 손상으로부터 보호하기 위해 정맥 수액 공급이 매우 중요합니다.
- 다중 치료 과정: 치료는 보통 며칠간의 주사 투여 후 휴식기를 가지며, 추후 혈액 검사 결과에 따라 추가적인 주사 치료가 필요할 수 있습니다.
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