Deferoxamine mesylate (Desferal)
Chelates iron from ferritin and hemosiderin but not from transferrin, cytochrome, or Hb. Helps prevent damage to liver and bone marrow from iron deposition.
Dosage:
Adult
1000 mg IV may be administered at a rate not to exceed 15 mg/kg/h; follow by a dose of 500 mg q4h for 2 doses; may administer additional IV infusion slowly over 24 h; not to exceed 6000 mg/d
Pediatric
20-40 mg/kg/d SC by infusion pump over 8-12 h 5 d/wk
With blood transfusions: 1-2 g IV slow infusion; not to exceed infusion rate of 15 mg/kg/h
Interactions:
Can cause loss of consciousness when administered with prochlorperazine
Contraindications:
Documented hypersensitivity; patients that do not have acute iron poisoning; severe renal disease and anuria (dose reduction after the loading dose should be considered in these circumstances)
Precautions:
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Tachycardia, hypotension, and shock may occur in patients receiving long-term therapy and could add to the cardiovascular collapse due to iron toxicity; GI adverse effects of the drug include abdominal discomfort, nausea, vomiting, and diarrhea, which may add to the symptoms of acute iron toxicity; flushing and fever are reported; increased susceptibility to Y enterocolitica infection.
