Classifications: chelating agent; antidote; Therapeutic: antidote
Pregnancy Category: C
500 mg vials
Chelating agent isolated from Streptomyces pilosus with specific affinity for ferric ion and low affinity for calcium. Binds ferric ions to form a stable water soluble chelate
readily excreted by kidneys.
Main effect is removal of iron from ferritin, hemosiderin, and transferrin of patient in iron toxicity.
Adjunct in treatment of acute iron intoxication or iron overload.
To promote aluminum excretion.
Severe renal disease, anuria, pyelonephritis; primary hemochromatosis; acute infection; pregnancy (category C).
History of pyelonephritis; infants and children <3 y; elderly, cardiac dysfunction; lactation.
Route & Dosage
|Acute Iron Intoxication
Adult: IM/IV 1 g followed by 500 mg at 4 h intervals for 2 doses, subsequent doses of 500 mg q412h may be given if necessary (max: 6 g/24 h), infuse at ≤15
Child: IM/IV 15 mg/kg/h (max: 6 g/24 h)
Chronic Iron Overload
Adult/Child: IM 500 mg1 g/d SC 12 g/d (2040 mg/kg/d) infused over 824 h (Child, max: 6 g/d or 2 g/dose)
- Reconstitute by adding 2 mL sterile water for injection to 500 mg vial to yield 250 mg/mL. Dissolve drug completely before
it is withdrawn from vial.
- Administer SC dose over 824 h using portable minipump devices.
- Use IM route for all patients not in shock; preferred route for acute intoxication.
- For infants and children: Verify correct IV concentration and rate with physician.
PREPARE: IV Infusion: ?? Reconstitute by adding 5 mL sterile water for injection to 500 mg vial to yield 100 mg/mL.??After drug is completely dissolved, withdraw prescribed amount from vial and add to NS, D5W, or RL solution.
ADMINISTER: IV Infusion: ??Give initial dose at a rate not to exceed 15 mg/kg/h. ??Give subsequent 500 mg doses at a rate of 125 mg/h.??Do not infuse IV rapidly; such infusion is associated with the occurrence of more adverse effects.
INCOMPATIBILITIES Solution/admixture: Iron dextran.
- Store at room temperature 15°30° C (59°86° F) for not longer than 1 wk. Protect from light.
Adverse Effects (≥1%)Body as a Whole:
Hypersensitivity (generalized itching, cutaneous wheal formation, rash, fever, anaphylactoid reaction
Hypotension, tachycardia. Special Senses:
Decreased hearing; blurred vision, decreased visual acuity and visual fields, color vision abnormalities, night blindness,
retinal pigmentary degeneration. GI:
Abdominal discomfort, diarrhea. Urogenital:
Dysuria, exacerbation of pyelonephritis, orange-rose discoloration of urine. Other: Pain and induration at injection site.
Use with ascorbic acid
increases cardiac risk, prochlorperazine
may cause loss of consciousness.
Widely distributed in body tissues. Metabolism:
Forms nontoxic complex with iron. Elimination:
Primarily in urine; some in feces.
Assessment & Drug Effects
- Lab tests: Perform baseline kidney function tests prior to drug administration.
- Monitor injection site. If pain and induration occur, move infusion to another site.
- Monitor I&O ratio and pattern. Report any change. Observe stools for blood (iron intoxication frequently causes necrosis
of GI tract).
- Note: Periodic ophthalmoscopic (slit lamp) examinations and audiometry are advised for patients on prolonged or high-dose therapy
for chronic iron overload.
Patient & Family Education
- Deferoxamine chelate makes urine turn a reddish color.
- Report blurred vision or any other visual abnormality.