依地酸鈣鈉 (CaEDTA)
Edetate Calcium Disodium
Calcium Disodium Ethylenediaminetetra-acetate
別名: 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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Heavy metal toxicity (Chinchillas) | 30 mg/kg SC q12h | SC | q12h | Not specified | 🌎 NA |
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
牛
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
依地酸鈣鈉 (CaEDTA) 是一種重金屬螯合劑，在獸醫學中主要用於治療鉛和鋅中毒。雖然在小動物鉛中毒的治療中，口服的二巰基丁二酸 (Succimer/DMSA) 因腎毒性較低而越來越受歡迎，但 CaEDTA 仍是大型動物和鳥類重要的注射型解毒劑。
重要臨床提示： 絕對必須確保使用的是鈣鈉 (Calcium Disodium) 形式的 EDTA。若錯誤使用不含鈣的依地酸二鈉 (Na2EDTA)，會強烈螯合病患體內的血清鈣，導致迅速且致命的低血鈣症。
CaEDTA 具高度水溶性，且極度依賴腎臟清除，因此在治療期間維持充足的水分和監測腎功能至關重要。
作用機轉
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.
安全性與警告
禁忌症
- Patients with anuria
- Oral (PO) administration in the presence of lead in the GI tract (enhances absorption)
不良反應
- Renal toxicity (renal tubular necrosis)
- Depression (dogs)
- Vomiting
- Diarrhea
- Zinc deficiency (with chronic therapy)
- Pain at IM injection site
注意事項
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.
藥物交互作用
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
監測
- 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
藥物動力學
吸收
Well absorbed after either IM or SC administration.
分佈
Distributed primarily in the extracellular fluid. Does not penetrate erythrocytes or enter the CNS in appreciable amounts.
代謝
Not significantly metabolized.
排除
Rapidly excreted renally, either as unchanged drug or chelated with metals. Changes in urine pH or flow do not significantly alter excretion rate.
過量
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.
可用產品
劑型
- Injection solution: 200 mg/mL
獸醫用
- None commercially available in the USA; may be obtained through compounding pharmacies.
人用標示
- Edetate Calcium Disodium Injection Solution: 200 mg/mL in 5 mL ampules (1 gram/ampule) (Calcium Disodium Versenate)
各地核准狀態
POM (Prescription Only Medicine)
POM-V
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
重金屬中毒（例如誤食硬幣、含鉛油漆或金屬五金）是一種嚴重且可能危及生命的緊急情況。
- 需要住院： 由於此解毒劑具有潛在毒性，且重金屬中毒情況危急，您的寵物通常需要住院接受專業的密切監護、注射治療及靜脈輸液。
- 保護腎臟： 該藥物的作用是與金屬結合並迫使其隨尿液排出。靜脈輸液對於幫助沖洗腎臟並保護其免受損傷至關重要。
- 多個療程： 治療通常需要連續幾天的注射，隨後休息一段時間，並可能需要根據後續的血液檢查結果進行下一輪的注射治療。
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