Deferoxamine

Deferoxamine Brand Name– Desferal

What is Deferoxamine

Deferoxamine is an iron-chelating agent used in the treatment of acute iron intoxication and chronic iron overload secondary to multiple RBC transfusions (i.e., transfusional iron overload) in patients requiring multiple RBC transfusions such as those with thalassemia, sickle cell anemia, or other chronic anemias.

Initially produced as a ferric compound, the drug has the iron component chemically removed, resulting in an iron-free ligand. This ligand is then used to bind excess ferric ions in cases of iron poisoning or iron overload associated with transfusion-dependent anemia.

Deferoxamine can be used to remove iron in patients with primary hemochromatosis, but phlebotomy is generally preferred for this condition. Deferoxamine also chelates aluminum and increases its renal clearance, and the drug can be used as a diagnostic test for aluminum overload.

Deferoxamine was approved by the FDA in 1968.

Indications

  1. aluminum toxicity
  2. iron toxicity
  3. transfusional iron overload

For the treatment iron toxicity

for adjunctive therapy in acute iron toxicity

Side Effects

  1. abdominal pain
  2. acute respiratory distress syndrome (ARDS)
  3. anaphylactic shock
  4. angioedema
  5. arthralgia
  6. blurred vision
  7. cataracts
  8. corneal opacification
  9. cyanosis
  10. diarrhea
  11. dizziness
  12. dyspnea
  13. dysuria
  14. elevated hepatic enzymes
  15. encephalopathy
  16. erythema
  17. fever
  18. flushing
  19. growth inhibition
  20. headache
  21. hearing loss
  22. hypocalcemia
  23. hypotension
  24. infection
  25. injection site reaction
  26. leukopenia
  27. myalgia
  28. nausea
  29. night blindness
  30. optic neuritis
  31. paresthesias
  32. peripheral neuropathy
  33. pruritus
  34. rash
  35. renal failure (unspecified)
  36. retinopathy
  37. scotomata
  38. seizures
  39. sinus tachycardia
  40. thrombocytopenia
  41. tinnitus
  42. urticaria
  43. visual impairment
  44. vomiting

Monitoring Parameters

  • audiometry
  • ophthalmologic exam
  • serum creatinine/BUN

Contraindications

  • anuria
  • breast-feeding
  • children
  • driving or operating machinery
  • geriatric
  • growth inhibition
  • hearing impairment
  • heart failure
  • hemochromatosis
  • hepatic disease
  • infants
  • infection
  • intravenous administration
  • ocular disease
  • pregnancy
  • pyelonephritis
  • radiographic contrast administration
  • renal disease
  • renal failure
  • shock
  • visual disturbance

Interactions

  • Ascorbic Acid, Vitamin C
  • Cyclosporine
  • Deferasirox
  • Deferiprone
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Iron
  • Iron – Injectable Only
  • Iron Salts
  • Polysaccharide-Iron Complex
  • Prochlorperazine
  • Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
  • Vigabatrin
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