Deferoxamine mesylate
Deferoxamine mesylate (Desferal)
Deferoxamine mesylate
(deh-fer- OX-ah-meen)
Pregnancy Category: C Desferal (Rx)

Classification: Heavy metal antagonist (iron chelator)

Action/Kinetics: Binds to free iron, iron of ferritin, and hemosiderin forming ferrioxamine, which is a water-soluble chelate excreted by the kidneys (urine is a reddish color) as well as in the feces via the bile. Iron is not removed from hemoglobin, myoglobin, or cytochromes. Must be given parenterally for systemic activity. Adequate renal function is necessary for effectiveness. t 1/2, IV: 60 min. Rapidly metabolized by plasma enzymes and excreted in the urine.

Uses: Adjunct in treatment of acute iron intoxication. Chronic iron overload including thalassemia. Investigational: Accumulation of aluminum in bone in renal failure and in encephalopathy due to aluminum. May be helpful in Alzheimer's disease and some cancers.

Contraindications: Severe renal disease, anuria. Treatment of primary hemochromatosis.

Special Concerns: Use in pregnancy only if clearly necessary. Use with caution for clients with pyelonephritis. Should not be used in children under the age of 3 years unless mobilization of 1 mg iron/day or more can be shown. Use deferoxamine and ascorbic acid with caution in geriatric clients due to a greater risk of cardiac decompensation.

Side Effects: Following long-term therapy. Allergic: Rash, itching, wheal formation, anaphylaxis. GI: Abdominal discomfort, diarrhea. Ophthalmologic: Blurred vision. Rarely, impaired peripheral, night, or color vision; cataracts, decreased visual acuity, retinal pigmentation abnormalities. Other: Dysuria, leg cramps, fever, tachycardia, high-frequency hearing loss. Following rapid IV use. Hypotension, urticaria, erythema. Following SC use. Local pain, erythema, swelling, pruritus, skin irritation.

How Supplied: Powder for injection: 500 mg

Dosage
?IM, IV, SC Acute iron intoxication.
Adults and children over 3 years of age, IM (preferred), initial: 1 g; then, 0.5 g q 4 hr for two doses; if necessary, then give 0.5 g q 4-12 hr, not to exceed 6 g/day. IV infusion ( only in emergencies such as CV collapse:) Same as IM at a rate not to exceed 15 mg/kg/hr. Begin IM therapy as soon as possible.
Chronic iron overload.
IM: 0.5-1.0 g/day; SC: 1-2 g (20-40 mg/kg/day) given by mini-infusion pump over an 8-24-hr period; IV: 2 g (given separately but at same time as each unit of blood and in addition to IM administration); IV rate not to exceed 15 mg/kg/hr.