British anti-Lewisite
By Domingo Tabangcura, Jr. and G. Patrick Daubert, MD

Clinical Use

Dimercaprol is the drug of choice for treatment of acute arsenic, inorganic or elemental mercury, gold, and inorganic lead (in combination with EDTA) poisoning (figure 7) In addition BAL has been used successfully in cases of arsine, antimony, bismuth, chromium, copper, nickel, tungsten, or zinc poisoning.[8, 13] One of the major advantages of chelation with BAL is its ability to remove heavy metals from intracellular sites because of its lipophilic nature.[15] Dimercaprol is an alternative in the treatment of Wilson's disease in patients intolerant of penicillamine and trientine.[13]

Figure 7. Vial of BAL

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