Succimer

Overview

Succimer aci or dimercaptosuccinic acid is the organosulfur compound with the formula (HSCH)₂(CO₂H)₂. It is a dicarboxylic acid containing a two thiol functional groups. It is a white solid. Like many dithiols, it is a chelating agent, forming metal thiolate complexes. WP

Uses, dosage and effects

Medical uses

Succimer is sold under the brand name Chemet among others. It is a medication tool used to treat lead, mercury, and arsenic poisoning. When radiolabeled with technetium-99m, it is used in many types of diagnostic testing.[1][2] WP

Common side effects include vomiting, diarrhea, rash, and low blood neutrophil levels. Liver problems and allergic reactions may also occur with use. Whether use during pregnancy is safe for the baby is unclear.[1][3] WP

Dimercaptosuccinic acid is in the chelating agent family of medications. It binds to a metal atom, leading to increased clearance from the body via the urine. A full course of Succimer lasts for 19 days of oral administration. A second course should be given after more than two weeks break after the first course.[1] WP

Succimer has been used medically since the 1950s. It is on the World Health Organization's List of Essential Medicines. In the United States, no generic version was available as of 2015.[4–7] WP

Succimer is indicated for the treatment of lead poisoning in children with blood level measured above 45 μg/dL. The use of dimercaptosuccinic acid is not approved for prevention of lead poisoning in anticipation of exposure in known lead-contaminated environments. Dimercaptosuccinic acid can cross the blood–brain barrier of mice, but it is not known if this is also the case in humans. Even if dimercaptosuccinic acid cannot reverse the damages done to the central nervous system, it might prevent further deterioration.[8][9][10] WP

Succimer facilitates urinary excretion of lead, and with sufficiently aggressive treatment, can reduce lead content in the brain. It also increases urinary excretion of copper and zinc. Dimercaptosuccinic acid improved cognitive function in rats that had been exposed to lead, but reduced cognitive function in rats that had not been exposed to lead.[11][12] WP

History

History

Dimercaptosuccinic acid was first synthesized by V. L. Nirenburg in the Urals Polytechnic Institute, commissioned by one of the electrical enterprises of Sverdlovsk, Russia, which consumed many tons of mercury and was looking for a medicine to prevent poisoning of personnel. In 1957, Chinese scientists found that dimercaptosuccinic acid can effectively treat antimony poisoning due to overdose of tartar emetic. Pronounced protective effect in animal poisoning with arsenic and mercury was first shown by I. E. Okonishnikova in 1962. In 1984, the now-defunct Bock Pharmaceutical Company requested the FDA grant approval for orphan drug status under the brand name Chemet and the FDA approved of this in 1991. It provided exclusivity until 1998 which was conveyed to the successor Sanofi in 1996.[13][14][15] WP

Toxicity

Chemistry

Formula

C4H6O4S2 PC

CAS number

304-55-2 PC

Molar mass (g/mol)

182.2 PC

IUPAC name (computed by PubChem)

(2S,3R)-2,3-bis(sulfanyl)butanedioic acid PC

SMILES

[C@@H]([C@@H](C(=O)O)S)(C(=O)O)S PC

InChIKey

ACTRVOBWPAIOHC-XIXRPRMCSA-N PC

PubChem CID

2724354

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

User reports

Pop culture

No references added yet.

Sources

1. Other Succimer
2. Other Biersack HJ, Grünwald F. Thyroid Cancer. 2005
3. Other Succimer (Chemet) Use During Pregnancy
4. Journal / agency Miller AL. Dimercaptosuccinic acid (DMSA), a non-toxic, water-soluble treatment for heavy metal toxicity. Alternative Medicine Review. June 1998. PMID 9630737
5. Other Chappell WR, Abernathy CO, Calderon RL. Arsenic Exposure and Health Effects III. 1999
6. Other World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. 2019
7. Other Hamilton R. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. 2015
8. Journal / agency Aaseth J, Jacobsen D, Andersen O, Wickstrøm E. Treatment of mercury and lead poisonings with dimercaptosuccinic acid and sodium dimercaptopropanesulfonate. A review. The Analyst. March 1995. doi:10.1039/an9952000853 · PMID 7741240
9. Journal / agency Guzzi G, La Porta CA. Molecular mechanisms triggered by mercury. Toxicology. February 2008. doi:10.1016/j.tox.2007.11.002 · PMID 18077077
10. Journal / agency Clarkson TW, Magos L, Myers GJ. The toxicology of mercury--current exposures and clinical manifestations. The New England Journal of Medicine. October 2003. doi:10.1056/nejmra022471 · PMID 14585942
11. Journal / agency Smith D, Strupp BJ. The scientific basis for chelation: animal studies and lead chelation. Journal of Medical Toxicology. December 2013. doi:10.1007/s13181-013-0339-2 · PMID 24113857 · PMC3846979
12. Journal / agency Bradberry S, Sheehan T, Vale A. Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning. QJM. October 2009. doi:10.1093/qjmed/hcp114 · PMID 19700440
13. Journal / agency Liang Y, Chu C, Tsen Y, Ting K. Studies on antibilharzial drugs. Vl. The antidotal effects of sodium dimercaptosuccinate and BAL-glucoside against tartar emetic. Acta Physiol. Sin. 1957
14. Journal / agency Search Orphan Drug Designations and Approvals. 2013
15. Other Sanofi Buying An American Drug Concern. July 17, 1996

Text and values on this page are quoted from Wikipedia (CC BY-SA 4.0), PubChem (public domain). Each value links to the exact revision it came from.