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Desferrioxamine Mesilate

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At a glance

Desferrioxamine Mesilate is an iron chelator used for the treatment of acute iron poisoning, chronic iron overload, and aluminum overload.

Description

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.

Indications
  • Acute iron poisoning
  • Chronic iron overload (transfusion-dependent anemias)
  • Aluminum overload (in ESRF patients on dialysis)
Therapeutic class

Antidote preparations

Pharmacological class

Iron Chelator

Pharmacology

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.

Mechanism of action

Desferrioxamine binds to ferric iron, forming ferrioxamine, a stable complex that is excreted via the kidneys, eliminating iron toxicity and overload.

Dosage

Adult - Chronic iron overload: 20-60 mg/kg/day SC/IV infusion (3-7 times weekly).
Adult - Acute iron poisoning: 15 mg/kg/hr slow IV infusion (max 80 mg/kg/24hr) OR 2 g IM single dose.
Adult - Aluminum overload: 5 mg/kg once weekly (during last hour of dialysis or 5 hr before).

Administration

IM: Add 2 mL sterile water to each 500 mg vial or 8 mL to each 2 g vial. IV: Add 5 mL to each 500 mg vial or 20 mL to each 2 g vial (10% solution). Can be added to saline, glucose or Ringer's lactate for infusion.

Missed dose

Desferrioxamine is an injection medicine given by healthcare professionals. You cannot miss a dose yourself.

Side effects

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

Precautions & warnings

Impaired renal function; may color urine reddish-brown; may exacerbate aluminum-related encephalopathy and precipitate seizure; susceptible to infection; monitor urinary excretion of iron, ophthalmological, audiological and cardiac function.

Contraindications

Severe renal disease or anuria.

Drug interactions

Phenothiazines: Increased risk of neurological symptoms.
Ascorbic acid: Improves Fe excretion but should not be given during the 1st month of deferoxamine treatment (may worsen Fe toxicity).
Gallium-67: May affect imaging results.

Food interactions

It is not known whether it is safe to consume alcohol with Desferrioxamine. Please consult your doctor.

Use in pregnancy

Desferrioxamine may be unsafe during pregnancy. Please consult your doctor.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Use in lactation

It is not known whether Desferrioxamine is excreted in human milk. Caution is required.

Pediatric use

Pediatric acute iron poisoning: 1 g IM as a single dose.

Geriatric use

No specific dosage adjustment is necessary for elderly patients.

Renal / hepatic impairment

Renal impairment: Use with caution. Contraindicated in severe renal disease or anuria.
Hepatic impairment: No adequate information is available.

Overdose effects

No adequate information on overdose is available. Seek medical attention.

Storage conditions

Store below 25°C.

Chemical structure

Desferrioxamine Mesilate

Common questions

What is Desferrioxamine Mesilate used for?
It is used for acute iron poisoning, chronic iron overload, and aluminum overload.
What is the dosage of Desferrioxamine Mesilate?
Chronic iron overload: 20-60 mg/kg/day; Acute iron poisoning: 15 mg/kg/hr IV; Aluminum overload: 5 mg/kg once weekly.
What are the common side effects?
Flushing, hypotension, local pain, pruritus, visual disturbances, hearing loss, and pulmonary syndrome.
What precautions should be taken while taking Desferrioxamine?
Avoid rapid IV injection, monitor renal function, and note that urine may become reddish-brown.
Is Desferrioxamine safe during pregnancy?
Consult your doctor.
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.