Desferrioxamine Mesylate is indicated in Diagnosis of iron storage disease, Aluminum overload, Diagnosis of aluminum overload, Chronic iron overload, Acute iron poisoning.
Deferoxamine works in treating iron toxicity by binding trivalent (ferric) iron (for which it has a strong affinity), forming ferrioxamine, a stable complex which is eliminated via the kidneys. 100 mg of deferoxamine is capable of binding approximately 8.5 mg of trivalent (ferric) iron. Deferoxamine works in treating aluminum toxicity by binding to tissue-bound aluminum to form aluminoxamine, a stable, water-soluble complex. The formation of aluminoxamine increases blood concentrations of aluminum, resulting in an increased concentration gradient between the blood and dialysate, boosting the removal of aluminum during dialysis. 100 mg of deferoxamine is capable of binding approximately 4.1 mg of aluminum.
Intramuscular- Diagnosis of iron storage disease: Adult: 500 mg as a single dose. To estimate the excretion of Fe in urine over the next 6 hr. An excretion of >1 g suggests Fe storage disease and >1.5 g suggests a pathological cause. Intravenous- Aluminum overload: Adult: Patients with end-stage renal failure, hemodialysis or hemofiltration patients: 5 mg/kg once a wk by slow infusion during the last hr of the dialysis session or 5 hr before the session in more severe cases. For patients on peritoneal dialysis: 5 mg/kg once a wk (via slow IV infusion/ SC/ IM/ intraperitoneally) should be given before the final exchange of the day. Intravenous- Diagnosis of aluminum overload: Adult: 5 mg/kg given via slow IV during the last hr of the dialysis session. Increase in serum aluminium conc above baseline >150 ng/ml (measured at the start of the next dialysis session) suggests aluminium overload. Parenteral- Chronic iron overload: Adult: Initially, 500 mg via IV/SC infusion (usually given over 8-12 hr or in some patients, 24 hr). Usual effective dose range: 20-60 mg/kg daily. Admin 3-7 times a wk depending on extent of iron overload. If given via IM inj, initial dose: 0.5-1 g daily as 1 or 2 injections; maintenance dose is determined by response. Parenteral- Acute iron poisoning: Adult: Initial dose: 15 mg/kg/hr by slow IV infusion, reducing after 4-6 hr so that the total dose dose not exceed 80 mg/kg in 24 hr. It can also be given via IM Inj as a single dose of 2 g. Child: Given via IM injection: 1 g as a single dose.
Concomitant use of Prochlorperazine: Concurrent treatment with Deferoxamine and prochlorperazine, a phenothiazine derivative, may lead to temporary impairment of consciousness.
Concomitant use of Vitamin C: Where an iron-overload is associated with ascorbic acid deficiency, oral administration of Vitamin C in the standard dosage (150 - 250 mg daily) may serve to enhance excretion of the iron complex in response to Deferoxamine. Larger doses of Vitamin C fail to produce an additional effect.
Concomitant use of Erythropoietin: There is evidence that aluminum intoxication causes reduced erythropoiesis. In dialysis patients with iron and/or aluminum overload receiving Deferoxamine and erythropoietin, it is important to adjust the dosage of the latter when necessary. Regular monitoring of iron stores should also be conducted.
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.
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Since Ddeferoxamine mesylate is available only for parenteral administration, acute intoxication is unlikely to occur.
Store between 15-25 °C. Do not store above 25°C.
.png&w=384&q=75)