Deferoxamine

General
  • Type: Antidote
  • Dosage Forms:
  • Routes of Administration: IV, IM
  • Common Trade Names: Desferal

Adult Dosing

Iron toxicity
  • 1000mg IV; start at 5mg/kg/hr, increase up to 15mg/kg/hr as tolerated for up to 24hrs
  • Subsequent doses are 500mg increments guided by clinical status of patient / urine color
  • Recommended amount during first 24hr is 360mg/kg not to exceed 6g.

Pediatric Dosing

Iron toxicity
  • 15 mg/kg/h IV
  • Prolonged use >24-48 hours may increase risk of ARDS
  • 100mg deferoxamine chelates 9mg free iron

Special Populations
  • Pregnancy Rating:
  • Lactation risk:
  • Renal Dosing
    • Adult: Contraindicated in severe impairment or anuria.
    • Pediatric: Contraindicated in severe impairment or anuria
  • Hepatic Dosing
    • Adult: Not defined
    • Pediatric: Not defined

Indications
  • Systemic toxicity and iron level > 350 mcg/dL
  • Metabolic acidosis
  • Progressive symptoms
  • Serum iron level >500 mcg/dL

Contraindications
  • Allergy to class/drug
  • Renal failure patients not on hemodialysis

Adverse Reactions
  • Hypotension (pre-existing hypotension is NOT a contraindication to therapy)
  • ARDS
  • Yersinia enterocolitica sepsis[1]
  • Can see "vin rose" colored urine from chelated iron extretion
  • Cataracts with long term use
  • Angioedema
  • Flushing, urticaria, fever, myalgia, nausea, vomiting

Pharmacology
  • Half-life: 6h
  • Metabolism: Plasma
  • Excretion: Urine, bile/feces
  • Mechanism of Action:

Comments
  • Chelates iron and creates a water-soluble compound ferrioxamine that is renally excreted and can be dialyzed.[2]

See Also

References
  1. Mazzoleni G. et al. Yersinia enterocolitica infection with ileal perforation associated with iron overload and deferoxamine therapy. Dig Dis Sci 1991; 36:1154-1160.
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