Edetate disodium
(EDTA)
Edetate disodium
EDTA
Edetate disodium
( ED-eh-tayt)
Pregnancy Category: C Disotate Endrate (Rx)

Classification: Heavy metal chelator.

Action/Kinetics: Forms a soluble calcium chelate in the blood which is excreted through the urine. This leads to a lowering of serum calcium and a mobilization of calcium stores, especially from bone. When used to treat digitalis toxicity, edetate disodium exerts a negative inotropic effect on the heart and thus the chronotropic and inotropic effects of digitalis on the heart are antagonized. Also forms chelates with magnesium, zinc, and other trace elements. When used ophthalmically, calcified corneal deposits are dissolved from the conjunctiva, corneal epithelium, and anterior layers of the stroma.

Uses: Hypercalcemia. Ventricular arrhythmias associated with digitalis toxicity. Investigational: Ophthalmically to treat corneal calcium deposits, eye burns from calcium hydroxide, and eye injury by zinc chloride.

Contraindications: Anuria. Ventricular arrhythmias. To treat arteriosclerosis, atherosclerotic vascular disease, lead poisoning, or renal calculi by retrograde irrigation.

Special Concerns: Use during pregnancy only if the benefits clearly outweigh the risks. Use with extreme caution in digitalized clients as EDTA and calcium may reverse the desired effect of digitalis. Use with caution in clients with heart disease (e.g., CHF) or hypokalemia.

Side Effects: Metabolic: Electrolyte imbalance including hypocalcemia, hypokalemia, hypomagnesemia, hyperuricemia may occur during treatment. CV: Decrease in both systolic and diastolic pressure, thrombophlebitis, anemia. GI: N&V, diarrhea. CNS: Headache, numbness, circumoral paresthesia, fever. Other: Exfoliative dermatitis, nephrotoxicity, reticuloendothelial system damage with hemorrhagic tendencies. Rapid injection may produce hypocalcemic tetany and convulsions, respiratory arrest, and severe arrhythmias.

Laboratory Test Alterations: Alkaline phosphatase levels.

Overdose Management: Symptoms: Precipitous drop in calcium. Treatment: IV calcium gluconate which should be available at all times.

How Supplied: Injection: 150 mg/mL

Dosage
?IV Hypercalcemia, digitalis toxicity.
Individualized and depending on degree of hypercalcemia. Adults, usual: 50 mg/kg over 24 hr (up to 3 g/day may be prescribed); dose may be repeated for 5 consecutive days followed by a 2-day rest period with repeated courses, if needed, up to 15 doses. Pediatric: 40 mg/kg over 24 hr up to a maximum of 70 mg/kg/day. An alternative dosing regimen is 15-50 mg/kg/day, to a maximum of 3 g/day followed by a 5-day rest period between courses.
?Ophthalmic Calcium deposits, calcium hydroxide burns.
Adults and children: 0.35%-1.85% solution as an irrigation for 15-20 min.
Zinc chloride injury.
Adults and children: 1.7% solution as an irrigation for 15 min.