UNITHIOL

Unithiol has been used to treat patients with acute or chronic poisoning with organic and inorganic forms of mercury (Prod Info Dimaval(R) intravenous intramuscular injection solution, 2013; Toet et al, 1994; Campbell et al, 1986; Dargan et al, 2003).
Unithiol has been shown to increase urinary mercury excretion after excessive exposure to organic mercury (Drasch et al, 2007), inorganic mercury (Garza-Ocanas et al, 1997), and in patients with elemental mercury exposure (Torres-Alanis et al, 1995; Vamnes et al, 2003; Torres-Alanis et al, 2000).
In a study of patients with methylmercury poisoning, unithiol decreased mercury half life to 10 days, compared with a half life of 65 days in patients receiving no treatment and 60 days in patients receiving placebo (Clarkson et al, 1981).
In an open label study of patients with mercury poisoning secondary to gold mining, use of unithiol was associated with an increase in urinary excretion of mercury and a reduction in neurologic symptoms of poisoning (Bose-O'Reilly et al, 2003).

ARSENIC

Unithiol has been used in the treatment of acute and chronic arsenic poisoning (Kruszewska et al, 1996; Moore et al, 1994).
Unithiol has been shown to increase urinary arsenic excretion and has been associated with clinical improvement in patients with acute and chronic arsenic poisoning (Mazumder et al, 2001; Wax & Thornton, 2000; Heinrich-Ramm et al, 2003).

LEAD

Oral unithiol increased urinary excretion of lead in 6 children with chronic lead poisoning (Chisolm & Thomas, 1985).

BISMUTH

Unithiol has been used to treat patients with acute bismuth intoxication; it induces a small increase in renal elimination, but allows removal of bismuth by hemodialysis (Hruz et al, 2002).
In a patient with bismuth intoxication, unithiol increased urinary bismuth clearance (from a baseline of 2.2 L/min to 8.2 to 9.7 mL/min) and increased the amount of bismuth removed by hemodialysis (from none without unithiol to 10 to 52 mL/min with unithiol) (Stevens et al, 1995).

OTHER

In a study of 11 subjects, treatment with unithiol increased urinary excretion of copper (2 to 119 fold), selenium (3 to 43.8 fold), zinc (1.6 to 44 fold) and magnesium (1.75 to 42.7 fold) (Torres-Alanis et al, 2000).
Unithiol increased urinary copper excretion in patients with Wilson's disease (Wang et al, 2003).
In China, unithiol has been used to treat human poisoning with non-metallic pesticides, such as tetramine, nereistoxin, chloridmieform, and bactercide 402 (Chen & Lu, 2004; Chan & Chan, 2006). It is unclear what data supports this use.
The manufacturer states that unithiol may also be suitable to increase elimination of antimony, chromium and cobalt, but provides no data to support this (Prod Info DIMAVAL(R) oral capsules, 2004).

FORMS

Unithiol is available as ampoules containing 250 mg unithiol in 5 mL for injection (Prod Info Dimaval(R) intravenous intramuscular injection solution, 2013), and as 100 mg hard capsules available in packages of 3, 9 and 20 capsules (Prod Info DIMAVAL(R) oral capsules, 2004).

SOURCES

Unithiol is available outside the US from Heyl Chem-pharm Fabrik (Germany) (www.heyl-berlin.de) (Prod Info Dimaval(R) intravenous intramuscular injection solution, 2013). It is not approved for human use by the US FDA. In the US, unithiol has been obtained from compounding pharmacies for use in heavy metal intoxication.

-CLINICAL EFFECTS

GENERAL CLINICAL EFFECTS

USES: Unithiol, a chelator, is used as an antidote to treat mercury poisoning. Unithiol is available in Russia and Germany. It is not approved for human use by the US FDA. In the US, unithiol has been obtained from compounding pharmacies for use in heavy metal intoxication.

PHARMACOLOGY: Unithiol is a chelating agent. It has two neighboring SH groups, which form stable complexes with heavy metals such as mercury. This allows complexation of the heavy metal in serum, and the resulting metal-unithiol complex is then excreted into the urine via the kidneys.

EPIDEMIOLOGY: Exposure is uncommon.

WITH POISONING/EXPOSURE

OVERDOSE: No human overdose data available. Overdose may cause hypotension, nausea, weakness and vertigo. Mineral imbalance, particularly low levels of zinc and copper, may also develop after overdose.

WITH THERAPEUTIC USE

ADVERSE EFFECTS: Chills, fever and rashes are the most common adverse effects. Prolonged use may cause mineral imbalance (especially zinc and copper). Hypotension, nausea, vertigo and weakness may develop after rapid injection. Elevated aminotransferase concentrations, reduced white blood cell count, angina pectoris, loss of appetite, pain at the injection site, unpleasant hydrogen sulfide smell, and taste disturbance occurs rarely. An asthma attack can occur in patients with asthma following rapid administration.

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-FIRST AID

FIRST AID AND PREHOSPITAL TREATMENT

Prehospital GI decontamination is generally not necessary.

-RANGE OF TOXICITY

MAXIMUM TOLERATED EXPOSURE

Carcinogenicity Ratings for CAS4076-02-2 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
EPA (U.S. Environmental Protection Agency, 2011): Not Listed
IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

TOXICITY AND RISK ASSESSMENT VALUES

EPA IRIS

EPA Risk Assessment Values for CAS4076-02-2 (U.S. Environmental Protection Agency, 2011):

Not Listed

TOXICITY VALUES

LD50- (SUBCUTANEOUS)CAT:
- 150 mg/kg (Prod Info DIMAVAL(R) IV, IM injection, 2004)
LD50- (SUBCUTANEOUS)DOG:
- 150 mg/kg (Prod Info DIMAVAL(R) IV, IM injection, 2004)
LD50- (SUBCUTANEOUS)MOUSE:
- 2000 mg/kg (Prod Info DIMAVAL(R) IV, IM injection, 2004)

-STANDARDS AND LABELS

WORKPLACE STANDARDS

ACGIH TLV Values for CAS4076-02-2 (American Conference of Governmental Industrial Hygienists, 2010):

Not Listed

AIHA WEEL Values for CAS4076-02-2 (AIHA, 2006):

Not Listed

NIOSH REL and IDLH Values for CAS4076-02-2 (National Institute for Occupational Safety and Health, 2007):

Not Listed

OSHA PEL Values for CAS4076-02-2 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS4076-02-2 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

ENVIRONMENTAL STANDARDS

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS4076-02-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS4076-02-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA RCRA Hazardous Waste Number for CAS4076-02-2 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA SARA Title III, Extremely Hazardous Substance List for CAS4076-02-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS4076-02-2 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Not Listed

DOT List of Marine Pollutants for CAS4076-02-2 (49 CFR 172.101 - App. B, 2005):

Not Listed

EPA TSCA Inventory for CAS4076-02-2 (EPA, 2005):

Not Listed

LABELS

NFPA

NFPA Hazard Ratings for CAS4076-02-2 (NFPA, 2002):

Not Listed

-PERSONAL PROTECTION

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

PROTECTIVE CLOTHING

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 4076-02-2.

Specific recommendations and test data for this chemical were not found in the available manufacturers' product literature. A complete list of consulted manufacturers and references is presented below.

-PHYSICAL HAZARDS

FIRE HAZARD

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

FLAMMABILITY CLASSIFICATION

NFPA Flammability Rating for CAS4076-02-2 (NFPA, 2002):

Not Listed

FIRE CONTROL/EXTINGUISHING AGENTS

Editor's Note: An ERG guide with information appropriate to this material does not exist.

NFPA Extinguishing Methods for CAS4076-02-2 (NFPA, 2002):

Not Listed

EVACUATION PROCEDURES

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

AIHA ERPG Values for CAS4076-02-2 (AIHA, 2006):

Not Listed

DOE TEEL Values for CAS4076-02-2 (U.S. Department of Energy, Office of Emergency Management, 2010):

Not Listed

AEGL Values for CAS4076-02-2 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

NIOSH IDLH Values for CAS4076-02-2 (National Institute for Occupational Safety and Health, 2007):

Not Listed

CONTAINMENT/WASTE TREATMENT OPTIONS

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

SMALL LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

LARGE LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-PHYSICAL/CHEMICAL PROPERTIES

MOLECULAR WEIGHT

210.3

-REFERENCES

GENERAL BIBLIOGRAPHY

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National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromine Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2007d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039732a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromoacetone (Proposed). United States Environmental Protection Agency. Washington, DC. 2008e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187bf&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Calcium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae328&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Sulfide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037ff26&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Chlorobenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803a52bb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Cyanogen (Proposed). United States Environmental Protection Agency. Washington, DC. 2008f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187fe&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

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National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Germane (Proposed). United States Environmental Protection Agency. Washington, DC. 2008j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963906&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Hexafluoropropylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1f5&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

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Product Information: DIMAVAL(R) IV, IM injection, (RS)-2,3-bis(sulphany)propane-1-sulphonic acid, sodium salt-Monohydrate IV IM injection. HEYL Chemisch-pharmazeutische Fabrik GmbH & Co., Berlin, Germany, 2004.

Product Information: DIMAVAL(R) oral capsules, (RS)-2,3-bis(sulphanyl)propane-1-sulphonic acid, sodium salt-monohydrate oral capsules. Heyl Chemisch-pharmazeutische Fabrik GmbH & Co., 2004.

Product Information: Dimaval(R) intravenous intramuscular injection solution, 2,3-Bis(sulfanyl)propane-1-sulfonic acid intravenous intramuscular injection solution. Heyl Chem.-pharm. Fabrik (per manufacturer), Berlin, Germany, 2013.

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Classification | Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents