The active ingredient, in fact, is used to remove excess iron and aluminum from the body. It is administered parenterally and medicines containing it can be sold in pharmacies upon presentation of a specific medical prescription. As they are classified as class A drugs, their cost can be reimbursed by the National Health System (SSN), although in some cases it may be necessary to pay a small ticket.
Examples of Medicines containing Deferoxamine
- Deferoxamine Noriderm®
- Desferal®
During treatment with deferoxamine, however, it is advisable to immediately inform the doctor if:
- There is a drop in blood pressure and shock which can manifest itself as redness, rapid heartbeat, circulatory collapse, skin rashes (these effects could be caused by too high a rate of administration).
- They occur: high fever, shortness of breath, sore throat, abdominal pain, acute diarrhea or generalized malaise, as these could be signs of bacterial or fungal infection.
- There are changes in kidney function visible in blood tests (increase in blood creatinine levels);
- Visual and / or auditory disturbances arise.
- Severe respiratory failure occurs, particularly if the patient has "acute iron poisoning or thalassemia, as this effect could be caused by the administration of an excessive dose of the active ingredient.
Also, when undergoing deferoxamine treatment, it is very important to know that:
- Treatment with deferoxamine can cause seizures and accelerate the onset of dementia on dialysis. This occurs mainly in patients with aluminum-related brain diseases treated with high doses of the active ingredient. In order to prevent such effects, the doctor may prescribe the patient to administer clonazepam.
- Treatment with deferoxamine to reduce the accumulation of aluminum can cause a decrease in blood calcium levels and worsening of hyperparathyroidism.
- The urine of treated patients may take on a reddish color due to the presence of the active ingredient-iron complex.
Patient monitoring while using Deferoxamine
During deferoxamine therapy, the doctor will monitor the patient with blood and urine tests in order to regularly evaluate the effectiveness of the treatment and the blood levels of iron.
Diagnostic tests and Deferoxamine
If you have to undergo a scintigraphy that involves the use of gallium 67, you must inform your doctor, as it may be necessary to stop treatment with deferoxamine 48 hours before carrying out the examination in question.
Use of Deferoxamine in children and adolescents
Deferoxamine can also be used in children and adolescents, however, it may cause growth retardation. For this reason, the doctor will constantly and regularly monitor this category of patients during treatment with the active ingredient.
Driving and using machines
Treatment with deferoxamine can impair the ability to drive and use machines as it can cause neurological disorders, vision and hearing problems. In such situations, the above activities should be avoided.
;In any case, the doctor should be informed if you are taking, have recently taken or intend to take any kind of medicines or products, including non-prescription drugs (SOPs), over-the-counter drugs (OTC), herbal and phytotherapeutic products and homeopathic products.
and articular;Uncommon, rare and very rare side effects
Undesirable effects that may occur less commonly and more rarely during deferoxamine therapy include:
- Impaired hearing and / or tinnitus;
- He retched;
- Abdominal pain;
- Asthma;
- Appearance of blisters, swelling due to fluid accumulation and a burning sensation at the injection site;
- Lowering of blood pressure;
- Increased heart rate
- Vision problems;
- Fungal infections;
- Shock;
- Gastrointestinal inflammation caused by bacterial infections;
- Reduction in the number of platelets and white blood cells;
- Severe allergic reactions, including anaphylactic shock;
- Angioneurotic edema;
- Dizziness
- Emergence or worsening of brain diseases caused by aluminum-related dialysis, peripheral nerve disease, pins and needles;
- Severe respiratory failure;
- Pulmonary infiltration;
- Diarrhea;
- Rash all over the body;
- Convulsions;
- Muscle spasms
- Acute renal failure, renal tubulopathy, increased blood creatinine levels.
Deferoxamine overdose
In the event of a deferoxamine overdose, the following may occur:
- Lowering of blood pressure;
- Acceleration or decrease in heart rate;
- Gastrointestinal disorders;
- Transient loss of vision;
- Aphasia;
- Agitation;
- Headache;
- Nausea;
- Severe renal insufficiency.
In addition, severe respiratory failure has been described following the intake of very high doses of deferoxamine in patients with acute iron intoxication and in thalassemics. Treatment of overdose will be symptomatic and supportive, varying according to the patient's condition.
²⁺ and Ca²⁺, on the other hand, is substantially lower.Chelation occurs with a molar ratio of 1: 1, i.e. 1 gram of deferoxamine can theoretically bind 85 mg of trivalent iron or 41 mg of trivalent aluminum. Thanks to its chelating properties, the active ingredient can bind free iron both in the plasma and in the cells, forming the ferrioxamine complex (FO). The urinary excretion of this complex derives mainly from the turnover of plasma iron, while the iron present in the faeces mainly reflects intrahepatic chelation. Iron can be chelated by ferritin and hemosiderin, but relatively low in the presence of deferoxamine concentrations. clinically relevant. It should be stressed, however, that deferoxamine is unable to mobilize the iron contained in transferrin, hemoglobin or other substances containing a heme group.
Deferoxamine can also mobilize and chelate aluminum, forming an aluminoxamine (AlO) complex.
In summary, deferoxamine binds to excess iron and aluminum, forming a complex and favoring its removal mainly with urine and faeces.
, intravenous or intramuscular. Administration of deferoxamine is usually done by a doctor or nurse. The doctor will decide which route of administration to use and which dosage to use depending on the disorder to be treated. In any case, the dosages usually used in therapy will be reported below. For more information on both the dosage and how to use deferoxamine-based medicines, refer to the information on the package leaflet of the deferoxamine-based medicine you must take and ask your doctor for advice.
- Treatment of chronic iron accumulation: the average recommended dose is 20-60 mg / kg of body weight per day. The route of administration can be a slow subcutaneous infusion, or a lightweight portable pump can be carried for 8-12 hours.
- Treatment of acute iron intoxication: in these cases, deferoxamine is used in addition to other treatments. The most commonly used route of administration is continuous infusion into a vein (intravenous administration). The recommended dose is 15 mg / kg body weight per hour. Your doctor will reduce the dose after 4-6 hours or as soon as possible so as not to exceed the recommended dose of 80 mg / kg body weight per day.
- Treatment of chronic aluminum accumulation: the dose will be determined on a case-by-case basis by your doctor. In patients on dialysis, the recommended dose of deferoxamine is 5 mg / kg body weight administered by slow infusion into a vein once a week.
- Diagnosis of the accumulation of iron or aluminum:
- Evaluation of the accumulation of iron: The patient will be injected with a dose of 500 mg of deferoxamine intramuscularly and will be asked to collect urine over the next 6 hours to determine the iron content.
- Evaluation of the accumulation of aluminum: The level of aluminum in the blood will be determined just before dialysis and at the start of the next dialysis. Deferoxamine will be administered at a dose of 5 mg / kg body weight by slow infusion into a vein during the last 60 minutes of dialysis.
Since deferoxamine can be excreted in breast milk, you should tell your doctor if you are breastfeeding before taking the active substance. This health figure will provide the mother with all the necessary information.
