From the FDA Drug Label
Deferoxamine mesylate for injection, USP, is indicated for the treatment of acute iron intoxication and of chronic iron overload due to transfusion-dependent anemias Deferoxamine mesylate is an adjunct to, and not a substitute for, standard measures used in treating acute iron intoxication, which may include the following: induction of emesis with syrup of ipecac; gastric lavage; suction and maintenance of a clear airway; control of shock with intravenous fluids, blood, oxygen, and vasopressors; and correction of acidosis
The treatment of choice for iron (Fe) poisoning involves standard measures such as:
- Induction of emesis with syrup of ipecac
- Gastric lavage
- Suction and maintenance of a clear airway
- Control of shock with intravenous fluids, blood, oxygen, and vasopressors
- Correction of acidosis Deferoxamine mesylate is an adjunct to these standard measures for the treatment of acute iron intoxication 1.
From the Research
The treatment of choice for iron poisoning is deferoxamine (Desferal), an iron chelating agent that binds to free iron and facilitates its excretion through the kidneys. For severe iron poisoning, deferoxamine is typically administered intravenously at a dose of 15 mg/kg/hour, with a maximum dose of 6-8 grams per day 2, 3. Treatment should be initiated as soon as possible after iron ingestion, especially in symptomatic patients or those with serum iron levels exceeding 500 μg/dL. The duration of therapy depends on clinical response and iron levels, often continuing until serum iron levels normalize and symptoms resolve.
Key Considerations
- Supportive care is also essential, including gastrointestinal decontamination with whole bowel irrigation if the patient presents within a few hours of ingestion 3.
- Deferoxamine works by forming a water-soluble complex with iron called ferrioxamine, which gives urine a characteristic vin rosé (pink to orange) color, serving as a visual indicator of the drug's effectiveness.
- Patients may require intensive care monitoring during treatment due to potential complications of severe iron poisoning including metabolic acidosis, shock, and liver failure 4, 5.
- It is crucial to be aware of the potential risks of deferoxamine, such as pulmonary and cardiovascular toxicity, and to use the drug judiciously to minimize these risks 4, 5.