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
• 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.

See Also

• Iron toxicity