A “binder” is not automatically a general detoxifier. Some are highly specific medical antidotes, while others act mainly inside the gastrointestinal tract.
I am deliberately separating true binding/sequestration from ordinary antidotes. For example, fomepizole treats methanol poisoning but does not bind methanol, so it is not included.
Top 50 Human Binders and Their Exact Targets
| # | Human Binder / Sequestrant | Exact Target(s) |
|---|---|---|
| 1 | Activated charcoal | Many adsorbable drugs/toxicants: acetaminophen, aspirin/salicylates, carbamazepine, phenobarbital, theophylline, tricyclic antidepressants, quinine, some pesticides, etc. |
| 2 | Multiple-dose activated charcoal | Particularly enhances elimination of carbamazepine, phenobarbital, theophylline, salicylates, dapsone, quinine and selected other drugs |
| 3 | Cholestyramine | Bile acids; can interrupt enterohepatic recycling of chlordecone, lindane and some other lipophilic compounds |
| 4 | Colestipol | Bile acids; enterohepatic bile-acid sequestration |
| 5 | Colesevelam | Bile acids |
| 6 | AST-120 / spherical carbon | Intestinal precursors of indoxyl sulfate and other protein-bound uremic toxins |
| 7 | Prussian blue | Thallium and radioactive cesium-134/137 |
| 8 | Sodium polystyrene sulfonate | Potassium; ion-exchange resin |
| 9 | Patiromer | Potassium |
| 10 | Sodium zirconium cyclosilicate | Potassium |
| 11 | Sevelamer | Intestinal phosphate |
| 12 | Lanthanum carbonate | Intestinal phosphate |
| 13 | Calcium acetate | Intestinal phosphate |
| 14 | Sucroferric oxyhydroxide | Intestinal phosphate |
| 15 | Ferric citrate | Intestinal phosphate |
| 16 | Calcium carbonate | Intestinal phosphate |
| 17 | Calcium disodium EDTA | Lead; also binds some other divalent metals |
| 18 | Succimer / DMSA | Lead, arsenic, mercury |
| 19 | Dimercaprol / BAL | Arsenic, mercury, lead, gold, antimony, bismuth and some other metals |
| 20 | DMPS / 2,3-dimercapto-1-propanesulfonic acid | Primarily mercury and arsenic; also some other heavy metals |
| 21 | Penicillamine | Copper; also can chelate some other metals |
| 22 | Trientine | Copper |
| 23 | Deferoxamine | Iron; also aluminum and some other metals |
| 24 | Deferasirox | Iron |
| 25 | Deferiprone | Iron |
| 26 | Ca-DTPA | Radioactive plutonium, americium, curium |
| 27 | Zn-DTPA | Radioactive plutonium, americium, curium |
| 28 | Hydroxocobalamin | Cyanide — binds cyanide to form cyanocobalamin |
| 29 | Digoxin immune Fab | Digoxin |
| 30 | Digoxin immune Fab | Other cardiac glycosides including digitoxin, oleandrin, ouabain-related glycosides |
| 31 | Botulinum antitoxin | Free circulating botulinum neurotoxin |
| 32 | Human botulism immune globulin (BabyBIG) | Botulinum toxin types A and B |
| 33 | CroFab / Crotalidae polyvalent immune Fab | Pit-viper snake venom toxins |
| 34 | ANAVIP / crotalidae immune F(ab’)₂ | North American pit-viper venom toxins |
| 35 | Coral snake antivenom | Elapid neurotoxins from coral snake venom |
| 36 | Latrodectus antivenom | Black widow spider venom neurotoxins |
| 37 | Centruroides immune F(ab’)₂ | Scorpion venom neurotoxins |
| 38 | Calcium montmorillonite / NovaSil | Particularly aflatoxin B1 |
| 39 | Hydrated sodium calcium aluminosilicate (HSCAS) | Especially aflatoxin B1 |
| 40 | Bentonite / sodium bentonite | Particularly aflatoxin B1; variable binding of other mycotoxins |
| 41 | Clinoptilolite / zeolite | Certain mycotoxins and cationic compounds; binding is highly preparation-dependent |
| 42 | Smectite / diosmectite | Gastrointestinal toxins and irritants; adsorption of selected microbial/toxic compounds |
| 43 | Kaolin / kaolinite | Selected gastrointestinal toxicants; studied particularly for mycotoxins and paraquat |
| 44 | Yeast cell-wall preparations | Especially aflatoxin, with variable binding of zearalenone, ochratoxin, fumonisins and other mycotoxins |
| 45 | β-glucan / mannan-rich yeast adsorbents | Selected aflatoxins, zearalenone, ochratoxin and other mycotoxins |
| 46 | Chitosan | Certain fatty acids, bile acids and metal ions; experimental toxicant sequestration |
| 47 | Alginate | Certain metal ions, including experimental binding of lead and other cations |
| 48 | Pectin / modified citrus pectin | Proposed intestinal binding/excretion of lead, cadmium and other metals; human evidence is limited |
| 49 | Chlorella | Experimental binding/complexation of mercury and other metals; human evidence is limited |
| 50 | Polymethylsiloxane polyhydrate / Enterosgel | Broad intestinal adsorption of selected toxins, microbial products and drugs; spectrum depends strongly on compound |