Desferrioxamine

Desferrioxamine is a medication primarily used for the treatment of iron overload in conditions such as thalassemia, hemochromatosis, and transfusional hemosiderosis. It belongs to a class of drugs known as iron chelators, which bind to excess iron in the body and facilitate its removal through urine or feces. It is a iron chelating agent, available for intramuscular, subcutaneous and intravenous administration.

Indications

-Treatment of iron overload due to blood transfusions in patients with thalassemia or other chronic anemias. -Treatment of chronic iron overload in patients receiving multiple blood transfusions. -Acute iron poisoning.

Dosage

-Acute iron intoxication : I.M. injection for patients not in shock : Initially 1g followed by 500mg every 4 hours for 2 doses. Subsequent doses of 500mg are given 4-12 hourly depending on response. Maximum 6g in 24 hours. -Patients with cardiovascular collapse : I.V. infusion 50mg/kg/hour upto a maximum of 80mg/kg in 24 hours. Chronic iron overload : I.M. 0.5-1g daily. In addition 2g i.v. infusion given separately with each unit of blood transfused.

Contra-Indications

Hypersensitivity, severe renal disease or anuria except those on dialysis.

Special Precautions

When adminstered over prolonged periods, visual acuity tests, slit lamp examinations, funduscopy and audiometry are recommended periodically. Impaired renal function, children below 3 years. Increased susceptibility to infection, particularly for Yersinia species. Concomitant use of ascorbic acid. Severe fungal infections have been reported.

Side Effects

On I.V. injection : Flushing, urticaria, hypotension, shock, tachypnoea, hypoxaemia, tachycardia, cardiac arrhythmias, convulsions. On s.c. or i.m. : Local pain, prutitus, erythemia, swelling, GIT disturbances, dysuria, fever, allergic skin rashes. Leg carmps on long term therapy, Reversible ocular and auditory disturbances. Reduction of growth in very young children, thrombocytopenia.

Drug Interactions

-Concurrent use of deferasirox may increase the risk of renal toxicity. -Concurrent use of nephrotoxic drugs may potentiate renal toxicity. -Desferrioxamine may reduce the efficacy of iron-containing supplements or medications.