Pharmacology. Deferoxamine is a specific chelating agent for iron. It binds free iron and, to some extent, loosely bound iron (eg, from ferritin or hemosiderin). Iron bound to hemoglobin, transferrin, cytochrome enzymes, and all other sites is not affected. The red iron-deferoxamine (ferrioxamine) complex is water-soluble and excreted renally; it may impart an orange-pink (vin rosé) color to the urine. One hundred milligrams of deferoxamine is capable of binding 8.5 mg of elemental iron and 4.1 mg of aluminum in vitro. Deferoxamine and both the aluminoxamine and ferrioxamine complexes are dialyzable. The basic science literature supports the use of the drug, but clinical evidence of efficacy and safety is lacking.

Indications

1. 
   

   Deferoxamine is used to treat iron intoxication (See Iron) when the serum iron is greater than 450–500 mcg/dL or when clinical signs of significant iron intoxication exist (eg, shock, acidosis, severe gastroenteritis, or numerous radiopaque tablets visible in the GI tract by radiography).

   
   
2. 
   

   Deferoxamine sometimes is used as a “test dose” to determine the presence of free iron by observing the characteristic vin rosé color in the urine; however, a change in urine color is not a reliable indicator.

   
   
3. 
   

   Deferoxamine has also been used for treatment of aluminum toxicity in patients with renal failure.

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