Efficacy and expenses of succimer vs. d-penicillamine plus garlic in the treatment of lead poisoning: a retrospective cross-sectional study

Daru. 2021 Dec;29(2):477-481. doi: 10.1007/s40199-021-00407-7. Epub 2021 Jul 27.

Abstract

Purpose: Lead Poisoning is a major health problem in Iran. We aimed to compare efficacy of a standard regimen (Succimer) with that of a low-priced combination of D-penicillamine and Garlic in outpatients with lead poisoning.

Methods: In this retrospective cross-sectional study, year-long clinical files of outpatients with lead poisoning in two referral toxicology clinics in Mashhad, Iran were reviewed. A total of 79 patients (all men), received either Succimer or a combination of D-penicillamen plus garlic (DPN + Gar), for 19 and 30 days, respectively. Clinical and laboratory data, including blood lead level (BLL), were analyzed and treatment expanses were compared between the two regimens.

Results: Of 79 male patients, 42 were treated by DPN + Gar and 37 received Succimer. Mean BLL of DPN + Gar group before treatment (965.73 ± 62.54 µg/L) was higher than that of the Succimer group (827.59 ± 24.41) (p < 0.001). After treatment, BLL in both groups significantly reduced to 365.52 ± 27.61 µg/L and 337.44 ± 26.34 µg/L, respectively (p < 0.001). The price of a 19-day treatment with Succimer was approximately 28.6 times higher than a one-month course of treatment with garlic plus DPN. None of the treatments caused serious side effects in the patients.

Conclusion: Combination therapy with DPN + Gar is as effective as Succimer in Pb poisoning, while treatment with Succimer is significantly more expensive.

Keywords: Addiction; D-penicillamine; Garlic; Lead; Poisoning; Succimer.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Antidotes / administration & dosage*
  • Antidotes / economics
  • Cost-Benefit Analysis
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Garlic / chemistry*
  • Humans
  • Iran
  • Lead / blood
  • Lead Poisoning / blood
  • Lead Poisoning / drug therapy*
  • Male
  • Penicillamine / administration & dosage*
  • Penicillamine / economics
  • Phytochemicals / administration & dosage*
  • Phytochemicals / economics
  • Retrospective Studies
  • Succimer / administration & dosage*
  • Succimer / economics
  • Treatment Outcome

Substances

  • Antidotes
  • Phytochemicals
  • Lead
  • Succimer
  • Penicillamine