Dimercaprol
Dimercaprol (also known as BAL or British Anti-Lewisite) is a chelating agent used to treat acute heavy metal poisoning, particularly from arsenic, gold, mercury, and lead. It works by binding to heavy metal ions in the blood through its sulfhydryl groups, forming complexes that can be excreted through the kidneys. This medication is administered via intramuscular injection and is typically used in hospital or clinical settings for severe toxic exposures.
Dimercaprol is an injectable chelating agent used to treat acute heavy metal poisoning from arsenic, gold, mercury, and lead.
Key facts at a glance
- ATC
- V03AB09
- RxNorm
- 3445
- Generic
- Dimercaprol
- Class
- atc-v03
- Brands
- BAL in Oil
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second third trimesteruse lowest effective dose
use only if benefits outweigh risks for treating arsenic gold or mercury poisoning
fetal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingavoid
not recommended during breastfeeding due to unknown excretion in breast milk
monitor infant if exposure necessary
geriatric
elderlyreduce dose and monitor renal function
use with caution due to age-related decline in renal and hepatic function
monitor renal function and for adverse reactions
Use with caution and monitor for adverse effects.
pediatric_age
infantsweight-based dosing required
use with caution in infants; dosing based on body weight
close monitoring for adverse effects
Use with caution and monitor for adverse effects.
pediatric_age
childrenweight-based dosing
approved for use in children with appropriate weight-based dosing for arsenic gold or mercury poisoning
standard monitoring for efficacy and adverse effects
renal_impairment
mildmay require dose reduction
use with caution; monitor renal function
monitor renal function tests
Use with caution and monitor for adverse effects.
renal_impairment
severesignificant dose reduction recommended
use only if essential; significant dose reduction required
close monitoring of renal function and drug levels if available
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateuse with caution
use with caution; monitor liver function
monitor liver function tests
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA Approval Year
Original FDA approval for Dimercaprol
Drug class
ATC classification as antidote for heavy metal poisoning
Primary indication
Primary therapeutic use for heavy metal chelation
Administration route
Route of administration for BAL in Oil
Treatment of acute heavy metal poisoning, including arsenic, gold, and mercury toxicity. Also used for lead poisoning (often in combination with EDTA), and occasionally for other heavy metal exposures. It is not effective for cadmium or iron poisoning.
Dimercaprol contains sulfhydryl (-SH) groups that have a strong affinity for heavy metal ions. It binds to these metals, forming stable, water-soluble complexes that are then eliminated from the body through renal excretion, effectively reducing the toxic effects of the metals.
Administered via deep intramuscular injection only. May cause side effects such as hypertension, tachycardia, nausea, vomiting, and pain at the injection site. Requires close medical monitoring during treatment. Not suitable for chronic metal poisoning management.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 20, 2026. · Read our editorial policy