Loading...
Loading...
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Antimonium Metallicum
Brand Name
Antimonium Metallicum
Generic Name
Antimonium Metallicum
Active Ingredient
AntimonyCategory
Non-Standardized Insect Allergenic Extract [EPC]
Salt Form
Potassium Tartrate
Variants
8
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 6 [hp_C]/1 | PELLET | ORAL | 37662-2710 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-2714 |
| 10 [hp_M]/1 | PELLET | ORAL | 37662-2717 |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Antimonium Metallicum, you must consult a qualified healthcare professional.
| 30 [hp_C]/1 | PELLET | ORAL | 37662-2712 |
| 1 [hp_M]/1 | PELLET | ORAL | 37662-2716 |
| 100 [hp_C]/1 | PELLET | ORAL | 37662-2713 |
| 500 [hp_C]/1 | PELLET | ORAL | 37662-2715 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-2711 |
Detailed information about Antimonium Metallicum
Antimony, specifically in the form of Antimony Potassium Tartrate, is a trivalent antimonial compound historically used as an antiparasitic agent and emetic. It belongs to the class of trivalent antimonials and is primarily indicated for the treatment of various forms of schistosomiasis.
The dosing of Antimony Potassium Tartrate must be meticulously calculated and administered only by experienced healthcare professionals in a hospital setting. The standard historical regimen for Schistosoma japonicum involved a series of intravenous injections given every other day or three times a week.
Healthcare providers typically monitor the patient's electrocardiogram (ECG) before and after each dose to ensure no dangerous cardiac changes are occurring. If significant ECG abnormalities appear, the dose may be reduced or the treatment suspended.
Antimony Potassium Tartrate is generally not recommended for use in children unless no other therapeutic options are available. When used, the dosage must be strictly adjusted based on body weight (mg/kg). A typical pediatric dose may range from 0.5 mg/kg to 1 mg/kg per injection, with a total cumulative dose not exceeding 1 gram over the course of treatment. Pediatric patients require even more intensive monitoring for cardiac and gastrointestinal toxicity than adults.
Antimony is primarily excreted through the kidneys. In patients with impaired renal function (reduced GFR), the drug can accumulate rapidly, leading to severe heavy metal poisoning. Dosage must be significantly reduced, or the drug should be avoided entirely in cases of moderate to severe renal failure.
Since the liver is a major site of antimony distribution and complexation, patients with pre-existing liver disease (such as cirrhosis or hepatitis) are at an increased risk of hepatotoxicity. Close monitoring of liver enzymes (ALT, AST) is required, and dosing intervals may need to be lengthened.
Geriatric patients often have reduced cardiac reserve and declining kidney function. Therefore, they are at a much higher risk for antimony-induced arrhythmias and toxicity. Healthcare providers typically use the lowest effective dose and maintain continuous cardiac monitoring during administration.
Antimony Potassium Tartrate is never self-administered. It must be given via a slow intravenous (IV) infusion or slow IV push.
If a dose is missed during a treatment course, it should be administered as soon as possible under medical supervision. However, doses should never be doubled or given too close together, as this significantly increases the risk of cumulative toxicity. The treatment schedule will be adjusted by the healthcare provider to maintain the total cumulative dose target.
Signs of antimony overdose (stibialism) are severe and potentially fatal. Symptoms include:
In the event of an overdose, emergency measures include immediate cessation of the drug, supportive care for shock, and the administration of chelating agents like Dimercaprol (BAL), which can help bind the antimony and facilitate its excretion.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or attempt to source this medication outside of a legitimate clinical environment.
Antimony Potassium Tartrate is associated with a high incidence of side effects, many of which are a direct result of its heavy metal properties.
Antimony is a potent heavy metal with a very narrow therapeutic window. It must only be used when the diagnosis of a susceptible parasitic infection is confirmed and when alternative treatments are unavailable or inappropriate. Patients must be hospitalized or under very close clinical observation during the entire course of treatment. Because the drug accumulates in the body, the risk of toxicity increases with every subsequent dose.
No formal modern FDA black box warning exists for Antimony Potassium Tartrate, but it carries the equivalent of a 'High Toxicity' warning in all clinical pharmacopeias. The primary concern is Acute Cardiotoxicity. Healthcare providers are warned that sudden death can occur even in patients without pre-existing heart disease if the drug is administered too rapidly or if the cumulative dose exceeds the patient's tolerance.
Certain drugs must NEVER be used with Antimony because the risk of a fatal interaction is too high.
Antimony Potassium Tartrate must NEVER be used in the following circumstances:
Antimony Potassium Tartrate is generally considered a high-risk medication during pregnancy (historically categorized near Category X or C depending on the urgency). Antimony is known to cross the placental barrier. Animal studies and historical human data suggest that trivalent antimonials can be embryotoxic and may cause spontaneous abortion (miscarriage). There is also a theoretical risk of teratogenicity (birth defects) given the drug's interference with cellular metabolism. Its use is only considered in life-threatening parasitic infections where safer drugs like praziquantel have failed or are unavailable. If used, the patient must be informed of the high risk to the fetus.
Antimony is excreted into breast milk. Because of the high toxicity of the metal and the immature renal clearance of a newborn, breastfeeding is strictly contraindicated during treatment with Antimony. A nursing mother should discontinue breastfeeding and use formula, and she should wait several weeks after the final dose before resuming breastfeeding to allow the metal to clear from her system.
As noted in the dosage section, Antimony is not approved for routine use in children. The pediatric population is particularly sensitive to the emetic and cardiac effects of the drug. Growth and development should be monitored if a child undergoes a course of treatment, although the short duration of most antiparasitic regimens makes long-term growth suppression less likely than acute toxicity.
Antimony Potassium Tartrate is a trivalent antimonial. Its primary molecular target in parasites like Schistosoma is the enzyme phosphofructokinase (PFK). By forming a stable complex with the thiol groups of the enzyme, antimony prevents the phosphorylation of fructose-6-phosphate to fructose-1,6-bisphosphate. This effectively halts glycolysis, the parasite's only source of ATP (energy). In humans, while our PFK enzymes are somewhat different, high concentrations of antimony can still interfere with host metabolism, particularly in the heart and liver, which explains its toxicity.
The dose-response relationship for antimony is very steep, meaning a small increase in dose can lead to a large increase in both effect and toxicity. The time to onset for its antiparasitic effect is relatively slow, requiring several days of treatment to achieve significant parasite clearance. However, the emetic effect is almost instantaneous. Tolerance to the side effects does not typically develop; in fact, the drug often becomes less tolerated over time due to cumulative tissue loading.
| Parameter | Value |
Common questions about Antimonium Metallicum
Antimony, specifically Antimony Potassium Tartrate, is primarily used to treat schistosomiasis, a parasitic infection caused by blood flukes. It was historically one of the few effective treatments for the Schistosoma japonicum strain found in parts of Asia. While it has been largely replaced by the drug praziquantel, it remains a significant compound in the history of tropical medicine. It works by paralyzing the parasite's energy metabolism, leading to its death within the host's bloodstream. Because of its high toxicity, it is only used when other treatments are not suitable and must be administered in a hospital.
The most common side effects include intense nausea, vomiting, and a characteristic 'antimony cough' that occurs during the intravenous injection. Patients also frequently report muscle and joint pain, a metallic taste in the mouth, and general fatigue. These symptoms are often dose-related and may worsen as the treatment course progresses due to the accumulation of the metal in the body. Because it is highly irritating, it can also cause pain at the site of the injection. Most of these common effects resolve once the treatment is finished, but they require close medical management.
No, you should strictly avoid alcohol while being treated with Antimony. Alcohol can significantly increase the strain on your liver, which is already being stressed by the antimony metal. Furthermore, alcohol can lead to dehydration and electrolyte imbalances, both of which increase the risk of dangerous heart rhythm problems associated with antimony. Combining alcohol with this medication also increases the likelihood of severe gastrointestinal upset and dizziness. Always wait until your doctor confirms the drug has cleared your system before consuming alcohol.
Antimony is generally not considered safe during pregnancy and is typically contraindicated unless the mother's life is at risk. It is known to cross the placenta and can be toxic to the developing fetus, potentially leading to birth defects or miscarriage. Trivalent antimonials like this one are particularly concerning due to their high systemic toxicity. If you are pregnant or planning to become pregnant, you must inform your healthcare provider immediately. Safer alternatives are almost always preferred for treating parasitic infections in pregnant women.
While the drug begins to affect the parasites shortly after the first few injections, a full course of treatment usually takes 2 to 4 weeks to be effective. The parasites are not killed instantly; instead, their metabolism is slowly shut down, leading to their eventual death and clearance by the host's immune system. Follow-up tests are usually required several weeks after the treatment ends to ensure that all parasites have been eliminated. It is crucial to complete the entire prescribed course, even if you begin to feel better early on. Your doctor will monitor your progress through blood and stool tests.
Antimony is administered in a controlled clinical setting, so any decision to stop the drug will be made by your healthcare provider. If you are experiencing severe side effects like chest pain or extreme weakness, the doctor will stop the medication immediately. Unlike some psychiatric drugs, there is no 'withdrawal' syndrome from stopping antimony, but stopping too early may mean the parasitic infection is not fully cured. The main concern after stopping is the time it takes for the heavy metal to leave your organs. Your doctor will continue to monitor your heart and liver function even after the last dose is given.
Since Antimony is given by a healthcare professional in a hospital or clinic, you should notify your medical team immediately if a scheduled appointment is missed. They will reschedule the dose as soon as it is safe to do so. Do not attempt to 'make up' the dose by taking more later, as this can lead to toxic accumulation of the metal. The total treatment schedule may be extended to ensure you receive the full cumulative dose required to kill the parasites. Consistent dosing is important for the success of the treatment.
No, Antimony is not associated with weight gain. In fact, due to the common side effects of severe nausea, vomiting, and loss of appetite, many patients may actually lose weight during the treatment course. If you notice sudden weight gain accompanied by swelling in the legs or ankles, you should report this to your doctor immediately. This could be a sign of kidney or heart problems, which are serious side effects of the medication. Weight changes during this treatment are usually related to fluid balance or gastrointestinal distress rather than metabolic changes.
Antimony has many serious interactions with other drugs, especially those that affect the heart rhythm or liver function. It is vital that you tell your doctor about every medication you are taking, including herbal supplements and over-the-counter drugs. Specifically, drugs that prolong the QT interval (like certain antidepressants or antibiotics) can be fatal if combined with antimony. Diuretics that lower your potassium levels also make antimony much more dangerous for your heart. Your healthcare provider will review your entire medication list to prevent dangerous interactions.
Antimony Potassium Tartrate is an older chemical compound and is not protected by current patents, making it technically a generic substance. However, because it is so rarely used in modern medicine and requires specialized manufacturing to ensure purity and safety, it is not commonly found in local pharmacies. It is usually sourced through specialized pharmaceutical suppliers or international health organizations like the WHO for use in specific regions where schistosomiasis is endemic. You cannot buy this medication over the counter or with a standard retail prescription.
Other drugs with the same active ingredient (Antimony)
> Warning: Stop taking Antimony and call your doctor immediately if you experience any of these symptoms. These may indicate life-threatening toxicity.
Prolonged or repeated exposure to antimony can lead to chronic antimony poisoning. This is characterized by chronic fatigue, persistent muscle weakness, and permanent damage to the heart muscle (cardiomyopathy). There is also evidence from animal studies suggesting that long-term exposure to certain antimony compounds may have carcinogenic (cancer-causing) potential, particularly regarding lung and skin cancers, although this is less documented with short-term clinical use for parasitic infections.
While Antimony Potassium Tartrate does not have a modern 'Black Box' warning in the same way as newly approved drugs (due to its age and limited current use), the FDA historical data and clinical literature emphasize a Warning for Cardiotoxicity.
Summary of Warning: Antimony compounds are known to cause significant, dose-related changes in the electrocardiogram (ECG). Fatalities have occurred due to sudden cardiac arrest. Patients must undergo ECG monitoring before each dose. The drug should be discontinued immediately if there is evidence of significant QT prolongation or cardiac rhythm disturbances.
Report any unusual symptoms to your healthcare provider immediately. Regular blood tests and heart checks are a mandatory part of antimony therapy.
Patients undergoing treatment with Antimony require a rigorous monitoring schedule:
Antimony frequently causes dizziness, vertigo, and severe fatigue. Patients should not drive, operate heavy machinery, or engage in any hazardous activities until the full course of treatment is completed and all side effects have resolved. The physical weakness associated with the treatment often makes these activities impossible regardless of the dizziness.
Alcohol must be strictly avoided during treatment with Antimony. Alcohol can exacerbate the hepatotoxic effects of the drug and may increase the risk of gastrointestinal irritation and dehydration, further stressing the kidneys and heart.
Antimony treatment is usually given in a fixed course. It is not a drug that causes 'withdrawal' in the traditional sense, but stopping the treatment prematurely can lead to a relapse of the parasitic infection. However, if serious side effects (especially cardiac or hepatic) occur, the drug must be discontinued immediately. There is no tapering requirement for antimony; the focus after discontinuation is on supporting organ function while the body slowly clears the remaining metal.
> Important: Discuss all your medical conditions, especially heart, liver, or kidney problems, with your healthcare provider before starting Antimony.
Antimony can interfere with several laboratory parameters:
For each major interaction, the mechanism is usually pharmacodynamic (additive effects on the heart or liver) rather than pharmacokinetic (CYP enzyme competition). The clinical consequence is almost always an increased risk of organ toxicity. The management strategy is typically avoidance of the interacting drug or extremely intensive monitoring in a hospital setting.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter pain relievers.
Conditions requiring careful risk-benefit analysis include:
Patients who are allergic to one antimonial compound are highly likely to be allergic to others. There is also some evidence of cross-sensitivity with other heavy metal-based drugs (such as arsenic-based compounds like melarsoprol). If a patient has had a severe reaction to any metal-containing medication, Antimony Potassium Tartrate should be approached with extreme caution.
> Important: Your healthcare provider will evaluate your complete medical history, including heart and kidney health, before prescribing Antimony.
The elderly are at the highest risk for adverse outcomes with Antimony therapy. Age-related declines in the Glomerular Filtration Rate (GFR) mean the drug stays in the system longer. Furthermore, the prevalence of underlying heart disease in this population makes the risk of fatal arrhythmia significantly higher. Healthcare providers often consider the use of pentavalent antimonials or other classes of drugs as a safer alternative for geriatric patients.
For patients with a GFR between 30-60 mL/min, a 50% dose reduction is often necessary. For those with a GFR below 30 mL/min, the drug is generally avoided. Dialysis does not effectively remove antimony from the body because it is so highly bound to tissues and red blood cells.
In patients with Child-Pugh Class B or C hepatic impairment, the risk of worsening liver failure is high. Dosing should be approached with extreme caution, and treatment should be halted if AST/ALT levels rise to more than 3 to 5 times the upper limit of normal.
> Important: Special populations require individualized medical assessment and often require hospitalization for the duration of antimony therapy.
| Bioavailability | 100% (IV); <5% (Oral) |
| Protein Binding | >90% (primarily to hemoglobin in RBCs) |
| Half-life | Initial: 2 hours; Terminal: >24 hours (can be weeks in tissues) |
| Tmax | Immediate (end of IV infusion) |
| Metabolism | Non-CYP; Thiol conjugation and intracellular oxidation |
| Excretion | Renal 80% (within 48h); Fecal 20% (slow) |
Antimony Potassium Tartrate is classified as a Trivalent Antimonial Antiparasitic. It is closely related to Sodium Stibocaptate (another trivalent compound) and more distantly related to pentavalent compounds like Sodium Stibogluconate (Pentostam) and Meglumine Antimoniate (Glucantime). Within the provided EPC classes, it is also associated with 'Non-Standardized Insect Allergenic Extract' due to its chemical stability and historical use in various biological preparations.