Desferal (Deferoxamine Mesylate)

Description

Desferal, or Deferoxamine Mesylate, is a medication that works as an iron-chelating agent by binding to excess iron in the body and helping to remove it. This medication is often prescribed for patients with conditions that lead to iron overload, such as those who receive frequent blood transfusions for anemia or thalassemia. Desferal is available for administration through intramuscular, subcutaneous, and intravenous injections.

Directions

For the appropriate Desferal dosage, closely follow the instructions given by a healthcare provider. In most cases, it is administered in a clinical setting, such as a hospital or outpatient client. To treat acute iron intoxication, a starting dose of 1,000 mg may be introduced intravenously at a rate not exceeding 15 mg/kg/hr. Depending on the patient's response, additional 500 mg doses might be given every 4 to 12 hours at up to 125 mg/hr, with a cap of 6,000 mg within 24 hours. For chronic iron overload, Desferal is usually administered via subcutaneous infusion, with an average daily dose ranging between 20 mg/kg and 60 mg/kg.

Ingredients

Desferal contains the active ingredient Deferoxamine Mesylate.

Contraindications

Patients with any of the following may need to avoid Desferal:

• Known hypersensitivity to deferoxamine or any of its components
• Severe kidney disease or anuria—the absence of urine production

Cautions

• Consult a healthcare provider about the following before starting treatment with Desferal:
• Any medical conditions you have
• Other medications you take
• Any allergies you have
• Whether you’re pregnant or breastfeeding
• Rapid intravenous infusion of Desferal can lead to hypersensitivity reactions. To reduce this risk, it is recommended to administer it intramuscularly or by slow subcutaneous or intravenous infusion.
• Prolonged use of Desferal, especially at high doses or in patients with low ferritin levels, can lead to problems with hearing and vision. Regular monitoring for these side effects is important.
• There have been reports of acute renal failure and other kidney-related issues in patients taking Desferal. Monitoring for changes in renal function is recommended.
• Desferal can cause acute respiratory distress syndrome, particularly with high intravenous doses. It's important not to exceed the recommended daily dose.
• High doses of Desferal, especially when ferritin levels are low, can suppress growth in children. Reducing the dose may help resume normal growth rates.
• There have been cases of serious infections, including mucormycosis and Yersinia infections, some of which were fatal. If such infections occur, Desferal should be discontinued, and appropriate treatment should be started immediately.
• In patients with heart failure, avoid using Desferal with Vitamin C. If Vitamin C is to be used, it should be started one month after beginning Desferal treatment and should not exceed 200 mg daily in adults. Monitoring cardiac function is advised when both treatments are combined.
• In patients with aluminum overload, Desferal treatment can lead to neurological issues, including seizures, dialysis dementia, and worsening of hyperparathyroidism.
• Desferal may cause dizziness, affecting your ability to drive or operate machinery.
• Desferal can be harmful to an unborn baby. Women of childbearing potential should be informed about this risk and advised to use effective contraception.

Side Effects

Desferal can cause irritation, pain, and swelling at the injection site, along with generalized rash, allergic reactions, joint pain, fever, headaches, muscle pain, nausea, vomiting, and abdominal pain. More severe side effects include auditory and vision problems, kidney issues, lung problems, growth suppression, serious infections, and cardiac dysfunction when used with vitamin C. Symptoms such as fast heartbeat, low blood pressure, neurological disturbances, vision changes, and acute respiratory distress require immediate medical attention.

References:

1. Desferal (Deferoxamine Mesylate) Product Monograph. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2022.
2. Desferal (Deferoxamine Mesylate) Drug Label Information. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....