Deferoxamine (Deferoxaminum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Detoxifying agents, including antidotes

Included in the formulation
  • Desferal®
    lyophilizatesolution for injections 
    Novartis Pharma AG     Switzerland
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    ONLS

    АТХ:

    V.03.A.C.01   Deferoxamine

    Pharmacodynamics:

    The preparation binds to ferric ions / aluminum ions, forming a stable water-soluble complex.

    Pharmacokinetics:

    It is practically not absorbed in the gastrointestinal tract, therefore parenteral administration is recommended, is quickly metabolized in tissues and serum enzymes, is eliminated mainly by the kidneys, and also by the gastrointestinal tract. The half-life is 6 hours.

    Indications:

    Acute iron poisoning, transfusion hemosiderosis, diagnostic test to determine pathological deposits of aluminum and iron.

    Idiopathic primary hemochromatosis (in patients who can not do bloodletting due to concomitant diseases: acute anemia, hypoproteinemia).

    Idiopathic hemosiderosis of the lungs, hemosiderosis on the background of cirrhosis of the liver.

    Hemosiderosis (against the background of porphyrin disease); Acute poisoning of Fe3+. Treatment of chronic aluminum overload in patients with terminal stage of renal failure (undergoing hemodialysis) under the following conditions:

    - zAlleviation of the osseous system;

    - disal encephalopathy;

    - aNemia, associated with a high content of aluminum.

    ICD-10

    IV.E70-E90.E80   Disorders of porphyrin and bilirubin metabolism

    IV.E70-E90.E83.1   Metabolic disorders of iron

    IV.E70-E90.E83.8   Other disorders of mineral metabolism

    VI.G90-G99.G93.4   Encephalopathy, unspecified

    X.J80-J84.J84   Other interstitial lung diseases

    XIII.M80-M85.M83.4   Bone disease associated with aluminum

    XIV.N17-N19.N18.0   Terminal stage of kidney damage

    XIX.T36-T50.T45.4   Poisoning with iron and its compounds

    XIX.T51-T65.T56   Toxicity of metals

    XIX.T80-T88.T80   Complications associated with infusion, transfusion and medical injection

    XXI.Z00-Z13.Z01.8   Other specified special examination

    Contraindications:

    Anuria, hypersensitivity, the first trimester of pregnancy, lactation.

    Carefully:

    Severe kidney failure.

    Pregnancy and lactation:

    Category Food and Drug Administration (US Food and Drug Administration) - C. The drug is contraindicated in the first trimester of pregnancy. When using deferoxamine during lactation, breastfeeding should be discontinued.

    Dosing and Administration:

    The drug is administered intramuscularly, subcutaneously, intravenously.Dosing regimen is selected individually by the attending physician. For most patients, the daily dose is 20-40 mg / kg body weight.

    Side effects:

    From the cardiovascular system and hematopoiesis: collapse, arterial hypotension, thrombocytopenia.

    From the nervous system and sensory organs: a decrease in the severity of hearing, vision, sensorineal deafness, tinnitus, twilight vision, color perception disorders, cataracts.

    From the gastrointestinal tract: diarrhea, dyspeptic phenomena, disruption of the liver.

    Other: impaired renal function, irritation at the injection site, allergic reactions.

    Overdose:

    Tachycardia, arterial hypotension, gastrointestinal symptoms, acute temporary loss of vision, aphasia, agitation, headache, nausea, bradycardia. There may be acute renal failure, respiratory distress syndrome (when very high doses are administered intravenously). Treatment: there is no specific antidote. It is necessary to stop the introduction of the drug and take appropriate symptomatic measures. Deferoxamine can be withdrawn by hemodialysis.

    Interaction:

    Ascorbic acid (in combination paracetamol + ascorbic acid) In combination with deferoxamine increases the toxic effect of iron on the fabric (especially in the heart, causing the development of heart failure); assignment of preparations containing ascorbic acid conducted after determining the concentration of deferoxamine and to determine the excretion of iron, not earlier than 1-2 hours after infusion deferoxamine.

    The drug is not compatible with a solution of heparin.

    Physiological chloride (0.9%) solution of sodium should not be used as a solvent of dry matter - deferoxamine as a lyophilisate for the preparation of an injection solution, but after dissolution in water deferoxamine injectable physiological sodium chloride solution may be used for further breeding.

    Simultaneous treatment with deferoxamine derivatives and phenothiazine prochlorperazine can lead to temporary disturbances of consciousness.

    Scintigrams obtained with the use of gallium (67Ga), can be distorted due to the rapid excretion of urine associated with deferoxamine gallium (67Ga). It is advisable to interrupt the introduction of deferoxamine 48 hours before the scintigraphy.

    Special instructions:

    When used in high doses and / or long-term treatment, regular examinations of the oculist and audiometry are indicated.

    The drug can stain urine in a red-brown color.

    During the use of the drug is not recommended to drive vehicles or other mechanisms.

    Instructions
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