CDC Confirms Succimer Drug Shortage

The pharmaceutical company Recordati Rare Diseases is currently experiencing a shortage of their oral succimer product, CHEMET.external icon They expect the shortage to be resolved by May 2021. Recordati is currently the only U.S. supplier of this medication. Succimer is one of several medications used for the chelation of lead. Other medications include calcium disodium EDTA and dimercaprol.

Chelation Therapy: Factors and Considerations

A healthcare provider generally uses clinical judgement and a risk-benefit analysis to determine if a child needs chelation therapy and which medication to use. This decision involves a blood lead level (BLL) ≥45 µg/dL and several other factors: the patient’s exposure source, chronicity, symptoms, nutritional status, sociodemographic characteristics, and results of additional diagnostic/laboratory markers.

Before beginning chelation therapy, consider the following:

  • Consult with a clinician with experience in the treatment of childhood lead poisoning.
  • Stop further exposure by removing the child from the contaminated environment while an investigation and remediation are performed.
  • Request diagnostic imaging to look for foreign bodies if you suspect the child swallowed lead-contaminated dust, soil, or paint chips.  If these are found, whole bowel irrigation may be used before chelation.

AAP Recommendations

If a child has a BLL ≥45 µg/dL, the American Academy of Pediatrics (AAP) “Medical Management of Childhood Lead Exposure and Poisoning Recommendations for Health Professionalsexternal icon” recommends the following:

  • Confirm the BLL test results with a venous blood draw within 48 hours.
  • Consult with a medical specialist such as a medical or clinical toxicologist.
  • Involve a clinician (with experience in treating pediatric lead poisoning) in follow-up testing and any further case management.