Cobaltous Chloride in the Treatment of Certain Refractory Anemias

P, Weinsaft; Bernstein, Leo H. T.

doi:10.1097/00000441-195509000-00005

Cited by 12 publications

(14 citation statements)

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“…[21] Reports of very prolonged biological half-lives for cobalt in humans are common. [1][2][3][4][5][6][7] In the current study, there was no significant change in EPO concentrations following cobalt administration over the 10-day study period. [12] In that same study, 10% of the administered dose was still present one-year post cobalt administration.…”

Section: Discussionmentioning

confidence: 89%

Pharmacokinetics and selected pharmacodynamics of cobalt following a single intravenous administration to horses

Knych

Arthur

Mitchell

et al. 2014

Drug Testing and Analysis

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Cobalt has been used by human athletes due to its purported performance-enhancing effects. It has been suggested that cobalt administration results in enhanced erythropoiesis, secondary to increased circulating erythropoietin (EPO) concentrations leading to improvements in athletic performance. Anecdotal reports of illicit administration of cobalt to horses for its suspected performance enhancing effects have led us to investigate the pharmacokinetics and pharmacodynamic effects of this compound when administered in horses, so as to better regulate its use. In the current study, 18 horses were administered a single intravenous dose of cobalt chloride or cobalt gluconate and serum and urine samples collected for up to 10 days post administration. Cobalt concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS) and pharmacokinetic parameters determined. Additional blood samples were collected for measurement of equine EPO concentrations as well as to assess any effects on red blood cell parameters. Horses were observed for adverse effects and heart rate monitored for the first 4 h post administration. Cobalt was characterized by a large volume of distribution (0.939 L/kg) and a prolonged gamma half-life (156.4 h). Cobalt serum concentrations were still above baseline values at 10 days post administration. A single administration of cobalt had no effect on EPO concentrations, red blood cell parameters or heart rate in any of the horses studied and no adverse effects were noted. Based on the prolonged gamma half-life and prolonged residence time, regulators should be able to detect administration of a single dose of cobalt to horses.

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Section: Discussionmentioning

confidence: 89%

Pharmacokinetics and selected pharmacodynamics of cobalt following a single intravenous administration to horses

Knych

Arthur

Mitchell

et al. 2014

Drug Testing and Analysis

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“…[17] On CoCl 2 intake, the urinary cobalt concentration is higher in women (median: 109.7 nmol/mmol creatinine) than in men (38.4 nmol/mmol creatinine). The medicine was used for the treatment of anaemias of different etiologies, including septic infection, [12] myeloid hypoplasia, [22][23][24][25] sickle-cell disease, [26,27] rheumatoid arthritis, [28] and chronic kidney disease (CKD). [14] Clinical trials Clinical trials on the use of Co 2+ as an anti-anaemic agent were performed from the late 1940s to the late 1970s.…”

Section: Uptake and Excretion Of Inorganic Cobaltmentioning

confidence: 99%

“…[15] Following a single intravenous (IV) administration of inorganic cobalt in adult males, 40% of the cobalt was excreted during the first 24 h, 70% in one week and 80 % in one month, while 10 % was still present after one year. [28][29][30][31][32][33][34][35][36][37] Some of the most important clinical observations are summarized in the following. [10,21] Co 2+ salt (mostly CoCl 2 ) was usually administered as tablets and at daily doses of 25-300 mg (molar mass of CoCl 2 hexahydrate: 238 Da).…”

Section: Uptake and Excretion Of Inorganic Cobaltmentioning

confidence: 99%

“…[22] Voyce [23] reported on a patient with pure red cell aplasia (PRCA), whose [Hb] rose from <70 g/L to >120 g/L on treatment with 100 mg CoCl 2 twice a day (b.i.d.). [26] Weinsaft and Bernstein [28] administered daily 80 mg CoCl 2 to eight patients with therapy-resistant anaemias of differing etiologies. [24] Anaemia improvement was observed in four patients with sickle-cell anaemia treated with 300 mg CoCl 2 for six weeks.…”

Section: Uptake and Excretion Of Inorganic Cobaltmentioning

confidence: 99%

“…In another case of PRCA haematological recovery was achieved on two months oral treatment with 50 mg CoCl 2 b.i.d. [28] Geill [32] treated a total of 107 anaemic CKD patients with a combination of 55 mg iron and 20 mg CoCl 2 , b.i.d. [26] Weinsaft and Bernstein [28] administered daily 80 mg CoCl 2 to eight patients with therapy-resistant anaemias of differing etiologies.…”

Section: Uptake and Excretion Of Inorganic Cobaltmentioning

confidence: 99%

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Intolerability of cobalt salt as erythropoietic agent

Ebert¹,

Jelkmann²

2013

Drug Testing and Analysis

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Unfair athletes seek ways to stimulate erythropoiesis, because the mass of haemoglobin is a critical factor in aerobic sports. Here, the potential misuse of cobalt deserves special attention. Cobalt ions (Co(2+) ) stabilize the hypoxia-inducible transcription factors (HIFs) that increase the expression of the erythropoietin (Epo) gene. Co(2+) is orally active, easy to obtain, and inexpensive. However, its intake can bear risks to health. To elaborate this issue, a review of the pertinent literature was retrieved by a search with the keywords 'anaemia', 'cobalt', 'cobalt chloride', 'erythropoiesis', 'erythropoietin', 'Epo', 'side-effects' and 'treatment', amongst others. In earlier years, cobalt chloride was administered at daily doses of 25 to 300 mg for use as an anti-anaemic agent. Co(2+) therapy proved effective in stimulating erythropoiesis in both non-renal and renal anaemia, yet there were also serious medical adverse effects. The intake of inorganic cobalt can cause severe organ damage, concerning primarily the gastrointestinal tract, the thyroid, the heart and the sensory systems. These insights should keep athletes off taking Co(2+) to stimulate erythropoiesis.

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Veränderungen des roten Blutbildes bei Nierenkrankheiten

Keller¹

1968

Nierenkrankheiten

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Cobaltous Chloride in the Treatment of Certain Refractory Anemias

Cited by 12 publications

References 0 publications

Pharmacokinetics and selected pharmacodynamics of cobalt following a single intravenous administration to horses

Pharmacokinetics and selected pharmacodynamics of cobalt following a single intravenous administration to horses

Intolerability of cobalt salt as erythropoietic agent

Veränderungen des roten Blutbildes bei Nierenkrankheiten

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