Week/day | Treatment | Observation |
0/0 | DMSA 3 times per day for 5 days* | 1, 2, 3, 4, 5 |
Vitamins and milk¶ |
0/5 | DMSA twice a day for 14 days* | 2, 3, 4 |
Calcium and iron supplementation if necessary |
1/7 | | 2, 3, 4 |
3/21 | | 1, 2, 3, 4 |
5/35 | | 3 and other tests to check previous abnormalities or as clinically necessary |
7/49 | | 1, 3 |
9/63 | | 3 |
11/77 | | 1, 3 |
Lead levels are then obtained at 15 weeks and then every 1-2 months until <45 mcg/dL (2.17 micromol/L) with history and physical examination every other visit. The frequency of visits is individualized by patent's needs. |
Retreat if level rebounds to >80 percent of original blood level and is ≥45 mcg/dL (2.17 micromol/L). |
1. History and physical exam |
2. Complete blood count, urinalysis |
3. Venous lead level and free erythrocyte protoporphyrin |
4. Serum electrolytes, glucose, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, calcium, magnesium |
5. Iron panel (serum iron, total iron binding capacity [transferrin], and ferritin) |