No

Antidote

Acute iron intoxication when serum iron is >450-500 mcg/dL or when clinical signs of significant iron toxicity exist; chronic iron overload secondary to multiple transfusions; diagnostic test for iron overload; iron overload secondary to congenital anemias; hemochromatosis; removal of corneal rust rings following surgical removal of foreign bodies

C

Patients with anuria, primary hemochromatosis

Use with caution in patients with severe renal disease, pyelonephritis; may increase susceptibility to Yersinia enterocolitica

1% to 10%: Local: Pain and induration at injection site

<1%: Flushing, hypotension (especially with rapid injection), tachycardia, shock, edema, fever, erythema, urticaria, pruritus, rash, cutaneous wheal formation, abdominal discomfort, diarrhea, leg cramps, blurred vision, cataracts, hearing loss, anaphylaxis

Symptoms of overdose include hypotension, blurring of vision, diarrhea, leg cramps, tachycardia

Treatment is symptomatic and supportive

Can cause loss of consciousness when administered with prochlorperazine

Protect from light; reconstituted solutions (sterile water) may be stored at room temperature for 7 days

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

Absorption: Oral: <15%

Metabolism: In the liver to ferrioxamine

Half-life: Parent drug: 6.1 hours; Ferrioxamine: 5.8 hours

Elimination: Renal excretion of the metabolite and unchanged drug

Children and Adults:

Acute iron toxicity: I.V. route is used when severe toxicity is evidenced by systemic symptoms (coma, shock, metabolic acidosis, or severe gastrointestinal bleeding) or potentially severe intoxications (serum iron level >500 mg/dL). When severe symptoms are not present, the I.M. route may be preferred; however, the use of deferoxamine in situations where the serum iron concentration is <500 mg/dL or when severe toxicity is not evident is a subject of some clinical debate.

Dose: 15 mg/kg/hour (although rates up to 40-50 mg/kg/hour have been given in patients with massive iron intoxication); maximum recommended dose: 6 g/day (however, doses as high as 16-37 g have been administered)

Children:

Chronic iron overload: S.C.: 20-40 mg/kg/day over 8-12 hours (via a portable, controlled infusion device)

Aluminum-induced bone disease: 20-40 mg/kg every hemodialysis treatment, frequency dependent on clinical status of the patient

Adults: Chronic iron overload:

I.V.: 2 g after each unit of blood infusion at 15 mg/kg/hour

S.C.: 1-2 g every day over 8-24 hours

Dosing adjustment in renal impairment: Cl_cr <10 mL/minute: Administer 50% of dose

Has been used investigationally as a single 40 mg/kg I.V. dose over 2 hours, to promote mobilization of aluminum from tissue stores as an aid in the diagnosis of aluminum-associated osteodystrophy

Serum iron, total iron binding capacity; ophthalmologic exam and audiometry with chronic therapy

None reported

Loss of consciousness has been reported with concurrent use of prochlorperazine

No information available to require special precautions

No effects or complications reported

I.V.: Instructions depend on patient condition. You will be monitored closely for effects of this medication and frequent blood or urine tests may be necessary. Report chest pain, rapid heartbeat, headache, pain, swelling, or irritation at infusion site; skin rash; changes or loss of hearing or vision; or acute abdominal or leg cramps. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Do not breast-feed.

Iron chelate colors urine salmon pink

Powder for injection, as mesylate: 500 mg

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