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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Niccolum Carbonicum
Brand Name
Niccolum Carbonicum
Generic Name
Niccolum Carbonicum
Active Ingredient
Nickel Carbonate Hydroxide TetrahydrateCategory
Copper-containing Intrauterine Device [EPC]
Variants
8
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 30 [hp_C]/1 | PELLET | ORAL | 37662-3930 |
| 500 [hp_C]/1 | PELLET | ORAL | 37662-3933 |
| 6 [hp_C]/1 | PELLET | ORAL | 37662-3928 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Niccolum Carbonicum, you must consult a qualified healthcare professional.
| 1 [hp_Q]/1 | PELLET | ORAL | 37662-3935 |
| 100 [hp_C]/1 | PELLET | ORAL | 37662-3931 |
| 1 [hp_M]/1 | PELLET | ORAL | 37662-3934 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-3932 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-3929 |
Detailed information about Niccolum Carbonicum
Nickel Carbonate Hydroxide Tetrahydrate is a specialized chemical compound primarily utilized as a non-standardized allergenic extract for diagnostic patch testing and as a component in metal-based medical devices, including certain intrauterine systems.
For diagnostic purposes, Nickel Carbonate Hydroxide Tetrahydrate is administered using a standardized patch test protocol. The standard concentration for adult testing is typically 5% in a petrolatum vehicle. A small amount (approximately 20 mg of the ointment) is applied to a 10-12 mm diameter patch chamber.
Nickel Carbonate Hydroxide Tetrahydrate is not routinely recommended for use in children under the age of 6 unless the clinical suspicion of severe contact dermatitis is high. In older children and adolescents, the dosage and application protocol are generally the same as in adults; however, a lower concentration (e.g., 2.5%) may be used by some specialists to reduce the risk of an overly severe localized reaction (an 'angry back' reaction).
No dosage adjustment is required for topical diagnostic application in patients with renal impairment, as systemic absorption is negligible. However, in cases of systemic nickel toxicity (rare), renal function must be closely monitored to ensure adequate clearance of nickel ions.
No dosage adjustments are necessary for patients with liver disease, as the compound is not metabolized by the liver.
Elderly patients may have thinner skin (atrophic skin), which can increase the rate of penetration. Healthcare providers may choose to use smaller patch sizes or monitor the site more frequently for signs of excessive irritation.
Nickel Carbonate Hydroxide Tetrahydrate is strictly for professional diagnostic use and is not for self-administration. During the testing period, patients must adhere to the following instructions:
If a patch is accidentally removed or falls off before the 48-hour mark, the patient should contact their healthcare provider immediately. The test may need to be restarted on a different area of the skin to ensure accurate results.
An 'overdose' in the context of patch testing refers to an excessive localized reaction. Signs include:
In the event of an extreme reaction, the patch should be removed immediately, and the area should be washed with mild soap and water. Topical corticosteroids may be prescribed by a doctor to reduce inflammation.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
Most patients undergoing testing with Nickel Carbonate Hydroxide Tetrahydrate will experience some level of localized skin reaction, particularly if they are sensitive to nickel. Common side effects include:
Nickel Carbonate Hydroxide Tetrahydrate must only be administered by healthcare professionals trained in the interpretation of patch tests and the management of allergic emergencies. It is not for internal use, ophthalmic (eye) use, or application to open wounds. Patients should be screened for any history of reactive airway disease or previous severe reactions to metal-containing implants before the test is initiated.
No FDA black box warnings for Nickel Carbonate Hydroxide Tetrahydrate.
Nickel Carbonate Hydroxide Tetrahydrate must NEVER be used in the following circumstances:
Nickel Carbonate Hydroxide Tetrahydrate is classified as Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. While systemic absorption from a single patch test is minimal, nickel is known to cross the placenta. In animal studies, high doses of nickel salts have been associated with developmental toxicity. Therefore, patch testing is generally avoided during pregnancy unless the benefits of identifying a severe allergen outweigh the theoretical risks to the fetus.
It is unknown whether the small amount of nickel absorbed from a patch test is excreted in human milk in significant quantities. However, since nickel is a natural trace element in breast milk, a one-time diagnostic application is unlikely to cause harm to a nursing infant. Caution should be exercised, and the patch should never be applied to the breast or nipple area where the infant might come into direct contact with the substance.
Nickel allergy is increasingly common in children due to early ear piercing and exposure to electronic devices. Nickel Carbonate Hydroxide Tetrahydrate is approved for use in pediatric patients when contact dermatitis is suspected. However, clinicians must be mindful of the child's smaller body surface area and the potential for more vigorous physical activity, which may dislodge patches. The safety of long-term metal exposure from IUDs in the pediatric/adolescent population is a subject of ongoing clinical review.
Nickel Carbonate Hydroxide Tetrahydrate acts as a source of Nickel (II) ions. These ions function as haptens that penetrate the skin and form complexes with MHC (Major Histocompatibility Complex) molecules on the surface of antigen-presenting cells. Specifically, nickel ions can directly activate the Human Toll-like Receptor 4 (TLR4), which is a key component of the innate immune system. This activation triggers the primary inflammatory signal that, in sensitized individuals, leads to the recruitment of memory T-cells. This dual activation of both innate and adaptive immunity is what makes nickel such a potent and common allergen.
The dose-response relationship for Nickel Carbonate Hydroxide Tetrahydrate is well-characterized in dermatological literature. A concentration of 5% in petrolatum is sufficient to elicit a reaction in over 95% of sensitized individuals. The time to onset is typically 24 to 48 hours, reflecting the nature of Type IV delayed-type hypersensitivity. The duration of the effect (the visible rash) can last from 7 to 21 days depending on the individual's immune vigor and the use of post-test topical treatments.
| Parameter | Value |
Common questions about Niccolum Carbonicum
Nickel Carbonate Hydroxide Tetrahydrate is primarily used as a diagnostic tool in patch testing to identify nickel allergy. When applied to the skin in a controlled manner, it helps doctors determine if a patient's skin rash is caused by contact with nickel-containing items like jewelry or zippers. It is also used to screen patients before they receive medical implants, such as certain IUDs or orthopedic hardware, to ensure they won't have an allergic reaction to the device. This compound is essential for diagnosing allergic contact dermatitis, the most common form of metal allergy. Only a trained healthcare professional can perform and interpret this test.
The most common side effects are localized to the area where the patch was applied and include redness, itching, and small bumps. These symptoms are actually the intended result of the test if you are allergic to nickel. Some patients may also notice small blisters or a slight darkening of the skin at the test site that can last for a few weeks. Itching is the most frequent complaint and can be managed with cool compresses after the patch is removed. Most of these side effects disappear on their own within a week or two. If the reaction is severe or spreads, your doctor may prescribe a topical steroid cream.
There is no direct interaction between alcohol and the Nickel Carbonate Hydroxide Tetrahydrate used in patch testing. However, alcohol can cause your blood vessels to dilate, which might make the itching and redness at the test site feel more intense. It is generally best to avoid heavy drinking during the 48 to 96 hours of the testing period to ensure the skin remains as stable as possible. Alcohol does not change the accuracy of the test results themselves. Always follow any specific lifestyle restrictions provided by your allergist or dermatologist. If you have any concerns, discuss them with your healthcare provider.
Nickel Carbonate Hydroxide Tetrahydrate is generally avoided during pregnancy unless the test is absolutely necessary. While the amount of nickel absorbed through the skin during a patch test is very small, nickel can cross the placenta to the developing baby. Most doctors prefer to wait until after the baby is born to perform allergy testing to avoid any theoretical risks. If you are pregnant or planning to become pregnant, inform your doctor before the test is scheduled. They will weigh the benefits of the diagnosis against the potential risks. In most cases, delaying the test is the safest course of action.
As a diagnostic test for delayed-type hypersensitivity, Nickel Carbonate Hydroxide Tetrahydrate takes 48 to 96 hours to produce a definitive result. The patch is typically applied to the back and left in place for 48 hours, during which time the nickel ions slowly penetrate the skin. After the patch is removed, a doctor will look for an initial reaction, but a second reading is usually required 24 to 48 hours later. This is because allergic reactions to metals often take a few days to fully develop. You will not see an immediate 'hive' like you might with a pollen or food allergy skin prick test. Patience is key to ensuring an accurate diagnosis.
Nickel Carbonate Hydroxide Tetrahydrate is not a daily medication, but a one-time diagnostic application. 'Stopping' it simply involves the healthcare provider removing the patch from your skin at the scheduled time. There are no withdrawal symptoms or 'rebound' effects associated with this compound. However, if you remove the patch yourself earlier than instructed, the test will likely be inaccurate and may need to be repeated. If you experience an unbearable burning sensation or extreme pain, you should contact your doctor immediately rather than just removing it. They will advise you on the best way to discontinue the test safely.
Since this compound is applied by a healthcare professional during a scheduled office visit, it is not possible to 'miss a dose' in the traditional sense. However, if your patch falls off or becomes loose before your 48-hour follow-up appointment, this is considered a compromised dose. You should not try to tape it back on yourself or apply any other substance to the area. Call your doctor's office immediately to explain what happened. They may need to reschedule the test or have you come in early to evaluate the site. Keeping the area dry and avoiding heavy exercise helps prevent the patch from falling off.
No, Nickel Carbonate Hydroxide Tetrahydrate does not cause weight gain. It is a diagnostic substance applied topically to a very small area of the skin for a short period of time. It does not enter the bloodstream in quantities large enough to affect your metabolism, hormones, or appetite. Any changes in weight you experience while undergoing patch testing would be unrelated to this compound. If you are concerned about weight changes, you should discuss them with your primary care physician to find the underlying cause. This nickel salt is strictly for identifying skin allergies.
Nickel Carbonate Hydroxide Tetrahydrate can be used while taking most medications, but certain drugs can interfere with the test results. Systemic steroids like prednisone and immunosuppressants used for autoimmune diseases can 'hide' an allergy by preventing the skin from reacting. Your doctor will likely ask you to stop these medications for a few weeks before the test. Antihistamines like Benadryl or Claritin generally do not stop the reaction but might make the itching less noticeable. Always provide your doctor with a full list of your current medications and supplements. They will tell you which ones are safe to continue and which should be paused.
Nickel Carbonate Hydroxide Tetrahydrate is a specialized chemical reagent rather than a standard prescription drug, so the concept of 'generic' vs. 'brand name' is slightly different. It is produced by various laboratory supply companies and manufacturers of allergenic extracts. While there are different 'brands' of patch test systems (like the T.R.U.E. TEST), the active nickel salt remains the same. Your doctor will select a high-quality, standardized version of the extract for your test. It is not something you can purchase at a retail pharmacy. The cost is usually covered by insurance as part of a diagnostic procedure.
> Warning: Stop taking Nickel Carbonate Hydroxide Tetrahydrate and call your doctor immediately if you experience any of these.
Prolonged or repeated exposure to nickel salts, though not typical in a diagnostic setting, can lead to chronic skin changes. These include lichenification (thickening and leathery texture of the skin) and chronic fissuring (painful cracks). There is also a theoretical risk of active sensitization, where the test itself causes the patient to develop a new allergy to nickel, though this is minimized by using standardized concentrations.
No FDA black box warnings currently exist for Nickel Carbonate Hydroxide Tetrahydrate when used as a diagnostic allergenic extract. However, healthcare providers are cautioned against its use in patients with a known history of severe, life-threatening systemic reactions to nickel.
Report any unusual symptoms to your healthcare provider.
While no routine blood tests (like CBC or LFTs) are required for a standard patch test, the following monitoring is essential:
Nickel Carbonate Hydroxide Tetrahydrate does not typically interfere with the ability to drive or operate machinery. However, if a patient experiences a severe localized reaction that causes significant discomfort or distraction, they should exercise caution.
There are no known direct interactions between alcohol and Nickel Carbonate Hydroxide Tetrahydrate. However, alcohol consumption can cause vasodilation (widening of blood vessels), which may exacerbate itching and redness at the test site.
Once the diagnostic period is over, the patch is removed. There is no 'tapering' required as this is a one-time diagnostic exposure. If the test was being used to evaluate an IUD and the result is strongly positive, the healthcare provider may discuss the surgical removal of the device.
> Important: Discuss all your medical conditions with your healthcare provider before starting Nickel Carbonate Hydroxide Tetrahydrate.
Nickel Carbonate Hydroxide Tetrahydrate does not interfere with standard blood chemistry or hematology tests. However, its presence can interfere with:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Patients who are sensitive to Nickel Carbonate Hydroxide Tetrahydrate often show cross-sensitivity to other divalent metals. The most common include:
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Nickel Carbonate Hydroxide Tetrahydrate.
In patients over 65, the skin's immune response may be delayed or diminished (immunosenescence). This can lead to 'weak' positive results that are difficult to interpret. Additionally, elderly patients are more likely to be taking multiple medications (polypharmacy) that could interfere with the test. Healthcare providers should ensure the skin on the back is sufficiently robust to handle the adhesive tape used for the patches.
As the primary route of nickel elimination is the kidneys, patients with end-stage renal disease (ESRD) or significant impairment should be monitored for any signs of systemic irritation, although the risk from a diagnostic patch is extremely low. No specific dose adjustment of the 5% concentration is standard practice.
Liver function does not affect the pharmacokinetics of Nickel Carbonate Hydroxide Tetrahydrate. No special precautions are required for patients with cirrhosis or hepatitis, provided their skin is healthy and they are not experiencing systemic pruritus related to liver failure (cholestatic pruritus), which could confound the test results.
> Important: Special populations require individualized medical assessment.
|---|---|
| Bioavailability | <1% (Topical) |
| Protein Binding | >90% (to Albumin/Histidine) |
| Half-life | 20-50 hours (Skin) |
| Tmax | 48-72 hours (Max reaction) |
| Metabolism | None (Inorganic salt) |
| Excretion | Renal (Systemic portion) |
Nickel Carbonate Hydroxide Tetrahydrate has the molecular formula [Ni4CO3(OH)6·4H2O] and a molecular weight of approximately 516.8 g/mol. It is a light green, crystalline powder that is practically insoluble in water but dissolves in acids. Its stability as a tetrahydrate is essential for its shelf-life in diagnostic kits.
It is classified as a Non-Standardized Allergenic Extract. It shares this class with other metal salts like Cobalt Chloride and Chromium Salicylate, as well as various plant and food extracts used in allergy medicine.