Calcium EDTA Injection Solution

Calcium EDTA Injection Solution

Available presentation(s): 10, 50, 100 mL. Verify the exact concentration and total active quantity on the prescription and dispensing label.

Introduction: Calcium disodium edetate (CaNa2EDTA) is a chelating agent used for significant lead poisoning. It is not interchangeable with disodium edetate; substitution can cause fatal hypocalcaemia.

Dosage: Only a toxicology service or suitably experienced prescriber should calculate and direct treatment according to blood lead concentration, symptoms, body weight/body-surface area, renal function and any need for combination therapy. The 200 mg/mL concentration must be diluted and administered exactly as prescribed; never use the product name ‘EDTA’ without specifying the calcium disodium salt.

Mechanisms of Action: Chelates extracellular lead to form a water-soluble complex excreted by the kidneys. It may also increase urinary loss of zinc and other metals.

Contraindications & Precautions: Contraindicated in anuria and significant active renal disease unless specialist benefit clearly outweighs risk. Monitor renal function, urine output, electrolytes, hepatic function, blood counts and blood lead. Ensure adequate urine flow. Intramuscular administration is painful and requires appropriate technique.

Interactions: Concurrent nephrotoxins increase renal risk. Zinc depletion can occur. Dimercaprol may be required first or concurrently in severe encephalopathy under specialist protocols. Do not mix with unverified products.

Adverse Reactions / Side Effects: Nephrotoxicity, proteinuria, haematuria, fever, malaise, chills, nausea, vomiting, headache, injection-site pain, transient hypotension, hepatic enzyme changes, cytopenias and zinc depletion may occur.

Pregnancy & Breastfeeding: Lead poisoning itself presents serious maternal and fetal risk. Use in pregnancy only under toxicology/obstetric specialist direction. Breastfeeding decisions require assessment of maternal lead burden and treatment.

Storage: Store under the conditions stated on the Optimus dispensing label and product-specific worksheet. Protect from light where labelled. Do not freeze unless explicitly validated. Maintain cold chain if the label requires refrigeration. Do not use after the assigned beyond-use date or if there is visible particulate matter, precipitation, colour change, loss of container integrity or evidence of improper storage. Once entered, follow the validated in-use time; do not assume a compounded vial is multi-dose.

References

• New Zealand Formulary (NZF), current online edition; product-specific approved data sheets where available; USP Pharmaceutical Compounding—Sterile Preparations; and Optimus Healthcare validated formulation, sterility/endotoxin controls and assigned beyond-use date.
• DailyMed. Edetate Calcium Disodium Injection—prescribing information, current edition. https://dailymed.nlm.nih.gov/
• US FDA. Compounding and the FDA: Questions and Answers. Updated 16 September 2025. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers