Which prescription medication is metabolized to diethyldithiocarbamate (DDC) and is used off-label as a nickel chelator?
Disulfiram. Disulfiram is a prescription drug that is metabolized by cleaving the disulfide bond to yield two molecules of DDC (a nickel chelator used outside of the USA). Disulfiram is used off-label to chelate nickel based on demonstrated efficacy in animal studies and anecdotal industry reports. It has demonstrated 70% protection from injury associated with nickel carbonyl.
Bowman N et al. Acute pneumonitis associated with nickel carbonyl exposure in the workplace. Clin Tox 2018; 56(3): 223-225. https://doi.org/10.1080/15563650.2017.1355057
Submitted by: Mary O’Keefe, PharmD on behalf of Acute and Intensive Care Section