Deferoxamine: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: [[Antidote]] | ||
*Dosage Forms: | *Dosage Forms: | ||
*Routes of Administration: | *Routes of Administration: IV, IM | ||
*Common Trade Names: | *Common Trade Names: Desferal | ||
==Adult Dosing== | ==Adult Dosing== | ||
===[[Iron toxicity]]=== | ===[[Iron toxicity]]=== | ||
*1000mg IV; start at 5mg/kg/hr, increase up to 15mg/kg/hr as tolerated for up to 24hrs | *1000mg IV; start at 5mg/kg/hr, increase up to 15mg/kg/hr as tolerated for up to 24hrs | ||
*Subsequent doses are 500mg increments guided by clinical status of | *Subsequent doses are 500mg increments guided by clinical status of patient / urine color | ||
*Recommended amount during first 24hr is 360mg/kg not to exceed 6g. | *Recommended amount during first 24hr is 360mg/kg not to exceed 6g. | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===[[Iron toxicity]]=== | |||
*15 mg/kg/h IV | |||
*Prolonged use >24-48 hours may increase risk of ARDS | |||
*100mg deferoxamine chelates 9mg free iron | |||
==Special Populations== | ==Special Populations== | ||
| Line 17: | Line 21: | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: Contraindicated in severe impairment or anuria. | ||
**Pediatric | **Pediatric: Contraindicated in severe impairment or anuria | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: Not defined | ||
**Pediatric | **Pediatric: Not defined | ||
==Indications== | ==Indications== | ||
| Line 36: | Line 40: | ||
deferoxamine therapy. Dig Dis Sci 1991; 36:1154-1160.</ref> | deferoxamine therapy. Dig Dis Sci 1991; 36:1154-1160.</ref> | ||
*Can see "vin rose" colored urine from chelated iron extretion | *Can see "vin rose" colored urine from chelated iron extretion | ||
*[[Cataracts]] with long term use | |||
*[[Angioedema]] | |||
*Flushing, urticaria, fever, myalgia, nausea, vomiting | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 6h | ||
*Metabolism: | *Metabolism: Plasma | ||
*Excretion: | *Excretion: Urine, bile/feces | ||
*Mechanism of Action: | *Mechanism of Action: | ||
| Line 47: | Line 54: | ||
==See Also== | ==See Also== | ||
*[[Iron toxicity]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Toxicology]] | |||
Latest revision as of 23:52, 20 September 2019
General
- Type: Antidote
- Dosage Forms:
- Routes of Administration: IV, IM
- Common Trade Names: Desferal
Adult Dosing
Iron toxicity
- 1000mg IV; start at 5mg/kg/hr, increase up to 15mg/kg/hr as tolerated for up to 24hrs
- Subsequent doses are 500mg increments guided by clinical status of patient / urine color
- Recommended amount during first 24hr is 360mg/kg not to exceed 6g.
Pediatric Dosing
Iron toxicity
- 15 mg/kg/h IV
- Prolonged use >24-48 hours may increase risk of ARDS
- 100mg deferoxamine chelates 9mg free iron
Special Populations
- Pregnancy Rating:
- Lactation risk:
- Renal Dosing
- Adult: Contraindicated in severe impairment or anuria.
- Pediatric: Contraindicated in severe impairment or anuria
- Hepatic Dosing
- Adult: Not defined
- Pediatric: Not defined
Indications
- Systemic toxicity and iron level > 350 mcg/dL
- Metabolic acidosis
- Progressive symptoms
- Serum iron level >500 mcg/dL
Contraindications
- Allergy to class/drug
- Renal failure patients not on hemodialysis
Adverse Reactions
- Hypotension (pre-existing hypotension is NOT a contraindication to therapy)
- ARDS
- Yersinia enterocolitica sepsis[1]
- Can see "vin rose" colored urine from chelated iron extretion
- Cataracts with long term use
- Angioedema
- Flushing, urticaria, fever, myalgia, nausea, vomiting
Pharmacology
- Half-life: 6h
- Metabolism: Plasma
- Excretion: Urine, bile/feces
- Mechanism of Action:
Comments
- Chelates iron and creates a water-soluble compound ferrioxamine that is renally excreted and can be dialyzed.[2]