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# EDETATE CALCIUM DISODIUM (CaNa₂EDTA)

## DOSING & ADMINISTRATION (Has been Doctor-Determined)

### STANDARD ADULT DOSE (Medical Lead Chelation Range)

- 1000–3000 mg/day (50–75 mg/kg/day), per doctor order
- **Maximum:** 75 mg/kg/day
- Dose must be calculated to patient weight & renal function

### IV INFUSION INSTRUCTIONS

Dilute dose in 250–500 mL of:

- 0.9% Sodium Chloride or D5W
- Infuse via pump over 1–3 hours (slower in sensitive patients)
- Monitor renal markers closely for multi-day protocols

### INFUSION FREQUENCY

Depends on clinical indication:

- **Acute toxicity:** Daily for up to 5 days
- **Chronic toxicity/integrative care:** 1–2× weekly as medically directed

### MAXIMUM INFUSION RATE

Not faster than 15 mg/kg/hour

## CLINICAL INDICATIONS

Doctor assessment is mandatory. CaNa₂EDTA is typically used for:

### Validated Indications

- Acute or chronic lead poisoning (serum lead above reference or symptomatic)
- Cadmium toxicity
- Supportive chelation where other metals are implicated, per doctor assessment

### Wellness/Integrative Context (Must Avoid Therapeutic Claims Under TGA)

You may describe it as:

"Used in integrative medical settings under medical supervision for the removal of certain heavy metals."

**Do not advertise it for:**

- Cardiovascular disease reversal
- Anti-aging
- Autism
- Any disease claims (TGA prohibited)

## CONTRAINDICATIONS

- Anuria or severe renal impairment
- Active hepatitis or significant hepatic dysfunction
- Pregnancy or breastfeeding
- Hypersensitivity to EDTA
- Hypocalcemia (although calcium disodium EDTA is safer than disodium EDTA, caution still applies)

## PRE-TREATMENT REQUIREMENTS

### Baseline Testing (Mandatory)

- CMP/U&Es (renal panel)
- LFTs
- CBC
- Serum electrolytes
- Urinalysis
- Heavy metals panel if indicated by the doctor

### Validated Indications

- Acute or chronic lead poisoning (serum lead above reference or symptomatic)
- Cadmium toxicity
- Supportive chelation where other metals are implicated, per doctor assessment

## POST-TREATMENT CARE

- Encourage additional hydration (oral + IV if required)
- Avoid strenuous activity for 24 hours
- Post-chelation supplementation (doctor-directed):
- Zinc
- Magnesium
- Trace minerals
- Antioxidants (Vitamin C, glutathione, NAC – where appropriate)

## Monitoring

- Re-test renal function every 3–5 infusions
- Heavy metals re-testing every 6–12 weeks if under ongoing chelation program

## ADVERSE EFFECTS

### Common

- Fatigue
- Metallic taste
- Headache
- Irritation at infusion site
- Hypotension (rapid infusion)

### Serious (Rare)

- Nephrotoxicity
- Hypocalcemia
- Arrhythmias
- Liver enzyme elevation
- Anuria/severe renal failure (stop immediately)

Stop infusion immediately and escalate per emergency protocol.

## EMERGENCY MANAGEMENT

### Signs of reaction

- Chest tightness
- Severe headache
- Tachycardia
- Hypotension
- Urticaria
- Reduced urine output

### Actions

1. Stop infusion
2. Keep IV cannula in situ
3. Vital signs q2–5 min
4. Apply oxygen if required
5. Contact supervising doctor
6. Activate emergency plan / ambulance if deterioration
7. Document incident fully

## SAFETY & COMPLIANCE POLICY

### Clinical Governance

- Chelation therapy MUST be ordered by the clinic's prescribing doctor
- Clear pathway required for medical review before and after treatment
- Protocols must align with TGA, AHPRA & NSW Poisons standards

### Scope of Practice

- Nurses and paramedics may administer under medical direction
- Must NOT advertise as treatment for unapproved indications
- Must NOT claim detox, cure, disease treatment, or guaranteed outcomes

### Documentation

- Doctor script
- Batch number & vial tracing
- Consent form
- Pre-assessment checklist
- Infusion chart
- Post-care notes

### Storage

- Store at 15–25°C
- Protect from light
- Single-use vial (discard unused portion)

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