Deferoxamine

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Desferal; Belgium: Desferal; Bulgaria: Desferal; Cyprus: Desferal; Czech Republic: Desferal; Denmark: Desferal; Finland: Desferal; France: Desferal, Deferoxamine; Germany: Deferoxaminmesilat, Desferal; Greece: Desferal; Hungary: Desferal; Ireland: Desferal; Italy: Desferal; Luxembourg: Desferal; Malta: Desferal; Netherlands: Desferal; Poland: Desferal; Portugal: Desferal; Romania: Desferal; Slovakia: Desferal; Slovenia: Desferal; Spain: Desferin; Sweden: Desferal; UK: Desferal, Desferrioxamine.

North America

Canada: Deferoxamine, Desferal, Desferrioxamine; USA: Deferoxamine, Desferal.

Latin America

Argentina: Desferal; Brazil: Desferal; Mexico: Desferal.

Asia

Japan: Desferal.

Drug combinations

Chemistry

Deferoxamine Mesylate: C~25~H~48~N~6~O~8~ CH~4~O~3~S. Mw: 656.79. (1) Butanediamide, N’-[5-[[4-[[5-(acetylhydroxyamino)pentyl]amino]-1,4-dioxobutyl]hydroxyamino]pentyl]-N-(5-aminopentyl)-N-hydroxy-, monomethanesulfonate; (2) N-[5-[3-[(5-Aminopentyl)hydroxycarbamoyl]propionamido]pentyl]-3-[[5-(N-hydroxyacetamido)pentyl]carbamoyl]propionohydroxamic acid monomethanesulfonate. CAS-138-14-7; CAS-70-51-9 (deferoxamine)(1966).

Pharmacologic Category

Heavy Metal Antagonists; Chelating Agent. Antidotes. (ATC-Code: V03AC01).

Mechanism of action

Complexes with trivalent ions (ferric ions) to form ferrioxamine, which are removed by the kidneys.

Therapeutic use

Adjunct in the treatment of acute iron intoxication. To promote iron excretion in chronic iron overload secondary to multiple transfusions frequently used in the treatment of thalassemia or other chronic anemias. Long-term therapy can slow the accumulation of hepatic iron and retard or eliminate the progression of hepatic fibrosis. Can delay and/or prevent the development of cardiac disease induced by iron overload in thalassemia and may also improve left ventricular function in asymptomatic patients with thalassemia who have subclinical cardiac dysfunction (with long-term SubQ therapy). May improve cardiac function in symptomatic cardiac disease (with high dosages of the drug). Long-term therapy in thalassemia may improve survival and, in the absence of extensive preexisting tissue alterations, may prevent and/or delay the development of other abnormalities associated with the disease such as diabetes mellitus.

Pregnancy and lactiation implications

Skeletal anomalies and delayed ossification in animal studies. Toxic amounts of iron cross the placenta and therefore, the drug should not be administered to pregnant women (especially during early pregnancy) or women who may become pregnant unless potential benefits outweigh possible risks to the fetus. Caution during lactation.

Unlabeled use

Removal of corneal rust rings following surgical removal of foreign bodies containing iron (topical use). Diagnosis or treatment of aluminum induced-toxicity associated with chronic kidney disease. Deferoxamine has been studied for potential beneficial effects in degenerative dementia of the Alzheimer’s type (Alzheimer’s disease, presenile or senile dementia), although the drug currently cannot be recommended for this use.

Contraindications

Hypersensitivity to deferoxamine or any component of the formulation. Patients with severe renal disease or anuria, or primary hemochromatosis.

Warnings and precautions

An adult respiratory distress syndrome-like condition, which can be fatal, has occurred in children and adults. Auditory disturbances and ocular toxicities reported following prolonged administration at high doses, or in low ferritin levels (elderly patients are at increased risk). Neurological symptoms may be exacerbated with high doses. Associated with dialysis dementia onset. Growth retardation. Treatment in aluminum toxicity may cause hypocalcemia and aggravate hyperparathyroidism. May enhance risk to infection with Yersinia enterocolitica and Y. pseudotuberculosi in iron overload. Flushing, hypotension, urticaria and shock may occur with rapid infusions. Mucormycosis reported. May impair cardiac function in combination with ascorbic acid (avoid combination in pre-existing cardiac failure). Urine discoloration is possible (reddish color).

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