DTPA chelation protocols May 2021.
The standard chelation strategy we use, also from the start of our clinical efforts is: Ca-DTPA day 1, Zn-DTPA day 2. We use a more simplified strategy than in our initial publication in Investigative Radiology, in part so it can be replicated at all centers.
Patient seated in reclining chair
1. 1 liter Normal saline bag.
2. iv start 22-24 g catheter.
3. start iv at medium pace. The concept is the full liter should go in over a 1 hour period.
4. May start with iv immune dampening.* proprietary at present
5. 5 ml vial of Ca-DTPA drawn into a 10 ml syringe.
6. inject 2.5 ml Ca-DTPA over 1 minute.
7. at 40 minutes patient to recline in chair with legs up.
8. May inject iv immune dampening * proprietary.
9. at 50 minutes inject the remaining 2.5 ml Ca-DTPA over 1 minute.
Repeat on day 2 same steps with Zn-DTPA.
1. Single day Ca-DTPA. Aggressive 1 day treatment. Removes more Gd, but also other metals. So supplementation a few days after chelation may be necessary- but does not seem so, if a good diet is consumed.
2. Single day Zn-DTPA. Gentle 1 day chelation. Also more specific removal of just heavy metals. No supplementation of metals needed.
3. 1/2 dose Zn-DTPA (still given as split dose).