Desferrioxamine mesilate
CLINICAL USE
Chelating agent:Acute iron poisoning Chronic iron or aluminium overload
DOSE IN NORMAL RENAL FUNCTION
SC/IV: Initially 500 mg then 20–60 mg/ kg/day 3–7 times a week. Exact dosages should be determined for each individualIM: 0.5–1 g daily as 1 or 2 injections, maintenance dose as per responseOral: acute iron poisoning: 5–10 g should be dissolved in 50–100 mL waterAluminium overload in
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IV infusion
, IM, SC or IP
IV infusion
IV infusion
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsAvoid prochlorperazine, methotrimeprazine (prolonged unconsciousness)Do not administer with blood
ADMINISTRATION
Reconstition
Dissolve contents of one vial (500 mg) in 5 mL of water for injection =10% solution. If for IV administration, the 10% solution can be diluted with sodium chloride 0.9%, glucose 5% or glucose/sodium chloride
Route
IV, SC (bolus or continuous infusion), IM, IP, oral
Rate of Administration
IV (acute overdose): Maximum 15 mg/kg/ hour. Reduce after 4–6 hours so that total dose does not exceed 80 mg/kg/24 hoursSC: Infuse over 8–24 hours. Local irritation may occur
Comments
The urine may appear orange/red in patients treated with desferrioxamine for severe iron intoxicationSC infusion is about 90% as effective as IV administration, which is now the route of choice in transfusion-related iron overloadIM injection is less effective than SC
OTHER INFORMATION
Studies suggest that during