Edetate calcium disodium, or calcium EDTA, is a parenteral drug used in the treatment of lead toxicity. It should not be confused with the noncalcium-containing salt (edetate disodium), which is used to treat hypercalcemia. Calcium EDTA reduces blood concentrations and depot stores of lead, and although it is used primarily in the treatment of lead poisoning, calcium EDTA also can be used as an antidote for other metal intoxications. Calcium EDTA was approved by the FDA for clinical use in 1953.
General Administration Information
For storage information, see the specific product information within the How Supplied section.
NOTE: Edetate calcium disodium (i.e., calcium EDTA) may aggravate symptoms associated with toxic lead levels in patients with blood lead levels > 70 mcg/dL. In these patients, calcium EDTA should be used in conjunction with dimercaprol. Patients may be severely dehydrated and urine flow should be established before the first dose is given, although excessive fluid intake should be avoided in patients with encephalopathy. The allowable upper limit of blood lead levels is 20 mcg/mL according to the World Health Organization.
Route-Specific Administration
Injectable Administration
-Edetate calcium disodium is administered intramuscularly or intravenously.
-Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Intravenous Administration
NOTE: Lethal increases in intracranial pressure have been reported in patients with lead encephalopathy and cerebral edema following intravenous administration. The intramuscular route is preferred for these patients. If the intravenous route is necessary, infuse slowly and monitor the patient carefully.
-Dilute the total daily dose of edetate calcium disodium injection in 250-500 mL of 5% Dextrose injection or 0.9% Sodium Chloride injection to a final concentration of 2-4 mg/mL.
-Intermittent infusion: Using an infusion pump, administer the diluted injection over 1 hour. NOTE: For the treatment of lead toxicity, the manufacturer recommends that the total daily dose be administered as a single infusion over 8-12 hours.
-Continuous infusion: Infuse over 8-24 hours. The infusion should be interrupted for 1 hour before a blood lead concentration is measured to avoid a falsely elevated value.
Intramuscular Administration
-Intramuscular injection is the preferred route of administration for patients at high risk for cerebral edema. Lethal increases in intracranial pressure have been reported in patients with lead encephalopathy and cerebral edema following the intravenous administration.
-Intramuscular administration of calcium EDTA is painful. To minimize pain at the injection site, lidocaine or procaine may be added to edetate calcium disodium injection. A final lidocaine or procaine concentration of 0.5% (5 mg/mL) can be obtained as follows: 0.25 mL of 10% lidocaine solution per 5 mL of edetate calcium disodium; or 1 mL of 1% lidocaine or 1% procaine solution per ml of edetate calcium disodium.
-Inject deeply into a well developed muscle. Aspirate prior to injection to avoid injection into a blood vessel. Massage injection site well following administration. Injection sites should be rotated.
Edetate calcium disodium, calcium EDTA may produce the same renal damage as seen with lead poisoning, manifesting as acute renal tubular necrosis which may result in fatal nephrosis. Treatment-induced nephrotoxicity is dose-dependent and may be reduced with adequate diuresis prior to administration. Patients may present with glycosuria, proteinuria, microscopic hematuria, and large epithelial cells in urinary sediment. Infrequently changes in distal tubules and glomeruli are seen. Discontinue treatment if anuria or severe oliguria develop. The proximal tubule hydropic degeneration usually recovers upon cessation of therapy.
Lead encephalopathy occurs more frequently in children than adults. Following the intravenous administration of calcium EDTA, some patients with lead encephalopathy and cerebral edema have experienced lethal increased intracranial pressure. The intramuscular route is preferred for these patients. However, intramuscular administration is painful at the site of injection. If the intravenous route is necessary, infuse slowly and monitor the patient carefully. Do not exceed the recommended dose.
Fever, chills, malaise, fatigue, myalgia, and arthralgia may occur following edetate calcium disodium, calcium EDTA administration.
Tremor, headache, numbness, and tingling may occur following edetate calcium disodium, calcium EDTA administration.
Cardiovascular reactions such as hypotension and cardiac rhythm irregularities have been reported with the use of edetate calcium disodium.
Zinc deficiency, hypercalcemia, anemia, and transient bone marrow depression have been associated with the use of edetate calcium disodium, calcium EDTA. Mild increases in hepatic enzymes (SGOT and SGPT) are common and return to normal within 48 hours after cessation of therapy.
Cheilosis or cheilitis, nausea, vomiting, anorexia, and polydipsia (excessive thirst) have been reported with the use of edetate calcium disodium, calcium EDTA.
Rash (unspecified) and a histamine-like reaction consisting of sneezing, nasal congestion, and lacrimation have been reported with with edetate calcium disodium, calcium EDTA administration.
Calcium EDTA is contraindicated for use in patients with anuria (or severe oliguria). The drug should not be administered to patients with active renal disease because this can reduce the excretion of the chelate and increase the possibility of nephrotoxicity. The EDTA-lead complex is highly nephrotoxic. In patients with anuria or oliguria, urine flow should be restored before reinstituting calcium EDTA therapy. Calcium EDTA should be used with caution in patients with dehydration secondary to vomiting or diarrhea, and urine flow should be reestablished before administration of the first dose of calcium EDTA. Once urine flow is reestablished, IV fluids must be restricted to basal water and electrolyte requirements.
Calcium disodium versenate (also known as edetate calcium disodium, calcium EDTA) is capable of producing toxic effects during the treatment of lead toxicity, and these effects can be fatal. Lead encephalopathy is relatively rare in adults, but occurs more often in children in whom it may be incipient and thus overlooked. The mortality rate in pediatric patients has been high. Intravenous administration of calcium EDTA can result in increased intracranial pressure and patients with lead encephalopathy and cerebral edema may experience a lethal increase in intracranial pressure following intravenous infusion. The intramuscular route is preferred for these patients. In cases where the intravenous route is necessary, avoid rapid infusion. The dosage schedule should be followed and at no time should the recommended daily dose be exceeded.
Calcium EDTA is contraindicated in patients with hepatitis.
No adequate and well-controlled studies have evaluated the effects of calcium EDTA on the human fetus; however, animal studies revealed no adverse fetal or reproductive effects in rats at doses up to 13-times the human dose. Another reproduction study in rats at doses up to 25- to 40-times the human dose revealed evidence of fetal malformations due to calcium EDTA, which were prevented by simultaneous supplementation of dietary zinc. Consider the benefits of the drug to the mother, the potential risks to the fetus, and the potential adverse effects to both resulting from untreated lead poisoning. The manufacturer recommends use during pregnancy only if clearly needed.
Advise patients requiring calcium EDTA for treatment of lead poisoning to avoid breast-feeding; lead is excreted in breast milk and is toxic to nursing infants. It is not known whether calcium EDTA is excreted in human milk.
For the treatment of lead toxicity:
-for the diagnosis of lead toxicity in patients with a blood lead concentration of 25 to 45 mcg/dL (i.e., the calcium EDTA mobilization test):
NOTE: Appropriate therapy should not be delayed for performance of a mobilization test, especially in patients who are symptomatic or whose blood lead concentration is > 45 mcg/dL. The American Academy of Pediatrics considers use of the mobilization test obsolete because of factors such as inconsistent prediction of the total body burden of lead, technical difficulties in administering the test, cost, and the potential for increased lead toxicity associated with administration of calcium EDTA alone.
Intramuscular or Intravenous dosage:
Adults and Adolescents: 500 mg/m2 IV (infused over 1 hour) or by IM injection. Urine is collected for 24 hours following administration of edetate calcium disodium. The mobilization test is considered positive if the ratio of mcg of lead excreted in urine to mg of calcium EDTA administered is greater than 1.
Children: 500 mg/m2 (Max: 1 g) IV over 1 hour, or by IM injection given as a single dose or 2 divided doses given 12 hours apart. Urine is collected for 24 hours following administration of edetate calcium disodium. If the ratio of mcg of lead excreted in urine to mg of calcium EDTA administered is greater than 1, the mobilization test is considered positive. Some experts recommend an 8-hour mobilization test using a single dose of 500 mg/m2 IV over 1 hour, or by IM injection. The test is positive if the ratio of mcg of lead excreted in urine to mg of calcium EDTA administered is greater than 0.5 to 0.6. Alternatively, a dose of 50 mg/kg (Max: 1 g) IM may be administered, with urine collected for 6 to 8 hours following administration of the dose. If the ratio of mcg of lead excreted in urine to mg of calcium EDTA administered is greater than 0.5 or urine lead concentration is greater than 1 mg/L, the test is considered positive.
-for the treatment of severe lead toxicity (i.e., encephalopathy or blood lead concentrations greater than 70 mcg/dL) in combination with dimercaprol:
Intravenous or Intramuscular dosage:
NOTE: Lead encephalopathy occurs more frequently in children than adults. Lethal increases in intracranial pressure have been reported in patients with lead encephalopathy and cerebral edema following the intravenous administration of edetate calcium disodium. The intramuscular route is preferred for these patients. However, intramuscular administration is painful at the site of injection. If the intravenous route is necessary, infuse slowly and monitor the patient carefully. Do not exceed the recommended dose.
Adults, Adolescents, Children, and Infants: The first dose of edetate calcium disodium should be given 4 or more hours after the initial dimercaprol injection, when urine flow has been established. Administer calcium EDTA 1,500 mg/m2 as an IV infusion, preferably over 12 to 24 hours, in combination with IM dimercaprol. If fluid restriction is desired (e.g., patients with encephalopathy or cerebral edema), the total dose can be given IM in equally divided doses at 8 to 12 hour intervals. Continue with calcium EDTA 1,500 mg/m2/day for 5 days, in combination with dimercaprol for at least the first 3 days of therapy. A second 5-day course of therapy (after at least 2 days without treatment) is recommended in patients with severe poisoning. Patients with a residual blood lead concentration greater than 70 mcg/dL should receive combined therapy with calcium EDTA plus dimercaprol. Patients with residual concentrations of 45 to 69 mcg/dL should receive calcium EDTA alone. A third course of therapy with calcium EDTA alone is required only if blood lead concentration rebounds to greater than 45 mcg/dL within 48 hours after the second treatment course. Wait at least 5 to 7 days before beginning a third course (if indicated), unless clinical status dictates earlier treatment.
-for the treatment of asymptomatic patients with blood lead concentrations of 45 to 69 mcg/dL:
Intramuscular or Intravenous dosage:
Adults, Adolescents, Children, and Infants: The calcium EDTA dosage is 1,000 mg/m2/day by IV infusion, administered over 8 to 24 hours (NOTE: The American Academy of Pediatrics suggests that therapy with oral succimer is preferred in patients with blood lead concentrations of 45 to 69 mcg/dL who do not have symptoms of lead encephalopathy). An alternative calcium EDTA regimen is 25 mg/kg/day by IV infusion over 8 to 24 hours. Therapy is generally continued for 5 days. Although the IV route is preferred, calcium EDTA may also be given IM in divided doses at 8 to 12 hour intervals. A second course of therapy may be required if the blood lead concentration rebounds to 45 mcg/dL or higher within 7 to 14 days after treatment. Allow 5 to 7 days without treatment before beginning a second course of calcium EDTA.
-for the treatment of asymptomatic patients with blood lead concentrations of 25 to 44 mcg/mL:
Intramuscular or Intravenous dosage:
Adults, Adolescents, Children, and Infants: The efficacy of chelation therapy in reducing the adverse cognitive effects of lead has not been established. The American Academy of Pediatrics recommends against routine chelation therapy in children with blood lead concentrations of 25 to 44 mcg/mL. Although chelation therapy is not routinely recommended, some experts may decide whether to use chelation therapy on the basis of results from carefully performed calcium EDTA mobilization tests. Treatment regimens vary from clinic to clinic.
-for the treatment of adults with lead nephropathy:
Intramuscular or Intravenous dosage:
Adults with SrCr less than 2 mg/dL: 1 g/m2/day IV over 8 to 24 hours (or by IM injection) for 5 days. May repeat monthly until lead excretion is reduced toward normal.
Adults with SCr 2 to 3 mg/dL: 500 mg/m2/day IV over 8 to 24 hours (or by IM injection) for 5 days. May repeat monthly until lead excretion is reduced toward normal.
Adults with SCr 3.1 to 4 mg/dL: 500 mg/m2 IV over 8 to 24 hours (or by IM injection), given every 48 hours for 3 doses. May repeat monthly until lead excretion is reduced toward normal.
Adults with SCr higher than 4 mg/dL: 500 mg/m2 IV over 8 to 24 hours (or by IM injection), given once per week. May repeat monthly until lead excretion is reduced toward normal.
Maximum Dosage Limits:
-Adults
1500 mg/m2/day IV or IM.
-Elderly
1500 mg/m2/day IV or IM.
-Adolescents
1500 mg/m2/day IV or IM.
-Children
1500 mg/m2/day IV or IM.
-Infants
1500 mg/m2/day IV or IM.
Patients with Hepatic Impairment Dosing
Specific dosage guidelines have not been established; however calcium EDTA is contraindicated in patients with hepatitis.
Patients with Renal Impairment Dosing
Specific dosage guidelines have not been established; however, dosage guidelines based on serum creatinine have been suggested for patients with lead nephropathy. These guidelines may also be useful for patients with preexisting renal impairment. The manufacturer states that edetate calcium disodium is contraindicated in patients with active renal disease.
*non-FDA-approved indication
Calcium Acetate: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Carbonate: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Carbonate; Famotidine; Magnesium Hydroxide: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Carbonate; Magnesium Hydroxide: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Carbonate; Magnesium Hydroxide; Simethicone: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Carbonate; Simethicone: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Chloride: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium Gluconate: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Calcium; Vitamin D: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Cardiac glycosides: (Major) The pharmacodynamic actions of edetate disodium oppose those of the cardiac glycosides.
Chlorpheniramine; Pseudoephedrine: (Major) Concomitant use of zinc supplements with calcium EDTA can decrease the effectiveness of both agents due to chelation. Zinc salts should not be administered until edetate calcium therapy is completed.
Chromium: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Digoxin: (Major) The pharmacodynamic actions of edetate disodium oppose those of the cardiac glycosides.
Insulin Aspart: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Aspart; Insulin Aspart Protamine: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Degludec: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Degludec; Liraglutide: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Detemir: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Glargine: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Glargine; Lixisenatide: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Glulisine: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Lispro: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin Lispro; Insulin Lispro Protamine: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulin, Inhaled: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Insulins: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Isophane Insulin (NPH): (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Magnesium Citrate: (Major) Administration of oral magnesium citrate with edetate disodium, disodium EDTA may result in binding of magnesium. Do not administer oral magnesium salts within 1 hour of edetate disodium, EDTA.
Magnesium Salts: (Major) Administration of oral magnesium with edetate disodium, disodium EDTA may result in binding of magnesium. Do not administer oral magnesium salts within 1 hour of edetate disodium, EDTA.
Magnesium: (Major) Administration of oral magnesium with edetate disodium, disodium EDTA may result in binding of magnesium. Do not administer oral magnesium salts within 1 hour of edetate disodium, EDTA.
Pyridoxine, Vitamin B6: (Major) Because edetate disodium chelates and lowers serum calcium, oral or parenteral calcium salts should not be administered concomitantly.
Regular Insulin: (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Regular Insulin; Isophane Insulin (NPH): (Minor) Use caution in administration of calcium EDTA to patients with diabetes mellitus who are receiving insulin therapy. Calcium EDTA chelates the zinc in selected exogenous insulins, thereby increasing the amount of insulin available to the body and decreasing the duration of the insulin dose. Alterations in blood glucose control may result. Diabetic patients receiving calcium EDTA may require adjustments in their insulin dosage.
Sodium Sulfate; Magnesium Sulfate; Potassium Chloride: (Major) Administration of oral magnesium with edetate disodium, disodium EDTA may result in binding of magnesium. Do not administer oral magnesium salts within 1 hour of edetate disodium, EDTA.
Succimer: (Moderate) Concomitant use of succimer and other chelation therapy such as edetate calcium disodium, calcium EDTA (CaNa2EDTA) with or without dimercaprol (BAL) is not recommended, as data are not available. Patients who have received CaNa2EDTA with or without dimercaprol may use succimer for subsequent treatment after an interval of 4 weeks.
Zinc Salts: (Major) Concomitant use of zinc supplements with calcium EDTA can decrease the effectiveness of both agents due to chelation. Zinc salts should not be administered until edetate calcium therapy is completed.
Zinc: (Major) Concomitant use of zinc supplements with calcium EDTA can decrease the effectiveness of both agents due to chelation. Zinc salts should not be administered until edetate calcium therapy is completed.
Calcium EDTA is a chelating agent with an affinity for divalent and trivalent metals. Once administered, the calcium component of calcium EDTA can be displaced by other divalent and trivalent metals, forming stable, soluble complexes that are then excreted by the kidneys. EDTA has a greater affinity for lead than for calcium and releases calcium to bind with lead. The noncalcium-containing formulation of EDTA should not be used to treat lead toxicity because it will preferentially bind calcium, and serious hypocalcemia can result.
One gram of edetate calcium disodium has the potential to combine with 620 mg of lead. Typically, however, only 3-5 mg of lead are excreted in response to a 1 g dose of the drug when administered to patients with acute lead poisoning or high levels of lead in the soft tissues.
Once calcium EDTA is circulating in the bloodstream and extracellular fluids, it can increase the urinary excretion of lead, but orally administered dosages of the drug increase the absorption of lead. Therefore, calcium EDTA is only administered subcutaneously, intravenously, or intramuscularly. The excretion of zinc is greatly increased following administration of calcium EDTA, and although mercury will displace calcium from its binding site on calcium EDTA, the drug is not effective in treating mercury poisoning, perhaps because mercury is too tightly bound to the ligands of the tissues or is sequestered in compartments of the body that calcium EDTA does not penetrate. Calcium EDTA is also not effective in the treatment of gold or arsenic poisoning.
Calcium EDTA is administered intravenously or intramuscularly. The drug distributes predominantly into the extracellular fluid and does not enter erythrocytes or the CNS to a significant extent. Calcium EDTA is not metabolized and is excreted primarily by the kidneys, with 50% excreted in 1 hour and 95% within 24 hours. The half-life is 20 to 60 minutes.
Affected cytochrome P450 isoenzymes: none
-Route-Specific Pharmacokinetics
Intravenous Route
Calcium EDTA is rapidly absorbed following intravenous administration.
Intramuscular Route
Calcium EDTA is rapidly absorbed following intramuscular administration.
-Special Populations
Renal Impairment
Impaired renal function can reduce the excretion of calcium EDTA, possibly increasing the drug's nephrotoxicity.