Deferoxamine

Intramuscular
Diagnosis of iron storage disease

Intravenous
Aluminum overload

Intravenous
Diagnosis of aluminum overload

Parenteral
Chronic iron overload

Parenteral
Acute iron poisoning

Use with caution.

Intramuscular:
Add 2 ml of sterile water for Inj to each 500 mg vial or 8 ml of sterile water for Inj to each 2 g vial.
Intravenous:
Add 5 ml of sterile water for Inj to each 500 mg vial or 20 ml of sterile water for Inj to each 2 g vial. This results in a 10% solution. This can then be added to saline, glucose or Ringer's lactate solution to be used as an infusion.

Incompatible with heparin.

Severe renal disease or anuria.

Impaired renal function; may color the urine reddish-brown, exacerbate aluminum-related encephalopathy and precipitate seizure (prophylactic with antiepileptic if at risk); susceptible to infection; monitor urinary excretion of iron, ophthalmological, audiological and cardiac function examinations; pregnancy.

Rapid IV injection: Flushing, urticaria, hypotension and shock. SC or IM injection: Local pain. Prolonged SC: Pruritus, erythema and swelling. GI disorders, dysuria, fever, allergic skin rashes, tachycardia, cardiac arrhythmias, convulsions and leg cramps; visual disturbances, cataract formation, hearing loss; may retard growth in very young childn. Pulmonary syndrome with high IV doses.

IM/IV/Parenteral/SC: C

Symptoms: Hypotension, tachycardia, GI disturbances, transient loss of vision, aphasia, agitation, headache, nausea, pallor, CNS depression, coma, bradycardia and acute renal failure. There is no antidote and treatment is symptomatic. Haemodialysis is helpful in drug removal.

Increased risk of neurological symptoms when used concurrently with phenothiazines. Ascorbic acid improves Fe excretion but it should not be given during the 1st mth of starting deferoxamine treatment as it may worsen Fe toxicity. May affect imaging results if given together with gallium-67.

Interferes with test for total iron-binding capacity and colorimetric Fe assays.

Description:
Mechanism of Action: Deferoxamine has a high affinity for ferric iron and forms chelates or stable water-soluble complexes with iron and other trivalent metal ions eg, aluminum. It removes free and bound iron from haemosiderin and ferritin, increasing the excretion of iron in urine and bile.
Pharmacokinetics:
Absorption: Poorly absorbed from the GI tract.
Metabolism: Metabolised mainly in the plasma.
Excretion: Chelates with metal ions, which are then excreted in the urine.

Before reconstitution, store below 25°C (77°F). After reconstitution: May store at room temperature for 7 days; protect from light. Do not refrigerate reconstituted solution.

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