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deferoxamine (Desferal)

Tradename: Desferal. (deferoxamine mesylate) Indication: 1) chelation therapy for iron poisoning 2) investigational use for treatment of Al+3 accumulation in renal failure 3) hemochromatosis 4) removal or corneal rust rings following surgical removal of foreign bodies Contraindications: - pregnancy [7] Dosage: 1) acute iron poisoning - 10-15 mg/kg/hr IV until serum iron < 250 ug/dL or until urine turns from "salmon" color to clear - 50 mg/kg IM/IV up to 500-1000 mg twice, 4 hours apart 2) chronic iron overload - 0.5-1 g IM QD - infusion: 20-40 mg/kg/day infused over 8-24 hours 3) max dose 6.0 g/day 4) infusion for > 24 hours associated with increased risk of ARDS (acute respiratory distress syndrome) [7] Powder for injection: 500 mg. Pharmacokinetics: 1) widely distributed to tissues 2) eliminated in the urine 3) chelation complex can be removed by dialysis Adverse effects: 1) not common (1-10%) - pain & induration at site of injection 2) uncommon (< 1%) - flushing, hypotension, tachycardia, shock, swelling, fever, erythema*, urticaria*, pruritus*, rash, abdominal discomfort, diarrhea, cutaneous wheal formation, leg cramps, blurred vision, cataracts, hearing loss, anaphylaxis * Administer antihistamines for allergic reactions. Mechanism of action: 1) chelates iron by binding ferric (Fe+3) ions 2) 1 g of deferoxamine chelates 85 mg of Fe+3 3) Fe+3:deferoxamine complex is H2O soluble & excreted in the urine 4) deferoxamine also chelates aluminum

Related

deferoxamine infusion test

General

chelating agent

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1155
  2. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. Department of Veterans Affairs, VA National Formulary
  6. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  7. NEJM Knowledge+ Question of the Week. Aug 21, 2018 https://knowledgeplus.nejm.org/question-of-week/4149/