DESFERRIOXAMINE MESILATE (DESFEROXAMINE MESILATE)

Iron and aluminium chelating antidote for iron poisoning and chronic iron overload, and aluminium overload

Dosage Forms

Powder for injection

500 mg

Uses

  • Iron poisoning
  • Chronic iron overload
  • Diagnosis of iron storage disease and certain anaemias
  • Aluminium overload

Dose and Duration

Give as a slow subcutaneous infusion

Only use intramuscular route when SC infusion is not feasible

Iron poisoning
Adult and child: By continuous IV infusion, up to 15 mg/kg/hour, reduced after 4–6 hours (max 80 mg/kg in 24 hours)

By IM injection, 2 g for an adult and 1 g for a child as a single dose

Chronic iron overload
Adult and child: 20–60 mg/kg/day in 2–3 divided doses by intermittent infusion or by continuous infusion over 24 hours, 3–7 times a week according to degree of iron over load. If serum ferritin <2000 nanogram/ml give about 25 mg/kg/day and 2000–3000 nanogram/ml about 35 mg/kg/day. Higher doses are only used if benefit to patient outweighs the risk of unwanted effects.

Doses higher than 50 mg/kg/day should only be used when needed in a patient who has completed growth

Maximum dose in children below 3 years 40 mg/kg/day

Diagnosis of iron storage disease and some anaemias
Adult and child: 500 mg as an IM injection
Aluminium overload (>150 nanogram/ml)
Adult and child: 100 mg bind 4.1 mg of aluminium ions

Preparation

  • Dissolve powder in water for injections to a 10% solution (1 ml of water for injections to 100 mg of powder or dis solve 500 mg of powder in 5 ml of water for injections).

    This solution can then be employed in infusion solutions such as normal saline, dextrose or dextrose-saline

Side Effects

  • Headache
  • Joint pain, muscle pain
  • Growth retardation and bone changes with doses > 60 mg/kg
  • Infiltration and eschar or crust
  • Injection or infusion site reactions
  • Cataracts

Interactions

  • Heparin (pharmaceutically incompatible with desferrioxamine solution; do not mix together)

Pregnancy

  • Do not use

Breastfeeding

  • Do not use

Storage

  • Once open, use immediately. Do not keep solutions

⚠️ Caution

  • Do not mix with blood or use the same IV line for administration
  • Monitor ferritin levels. Reduce dose when ferritin level falls below 1000 nanogram/ml due to increased risk of toxicity
  • Do eye and ear examinations before treatment and there after every 3 months during treatment
  • Monitor body weight and height in children at 3 month intervals due to risk of growth retardation
  • May exacerbate aluminium related encephalopathy when used alone
  • Use with caution in renal impairment
  • In breast feeding, only use if benefit outweighs risk
  • Only use clear solutions. Discard opaque, cloudy or dis coloured solutions