Desferal
Generic Name
Deferoxamine
Manufacturer
Novartis
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| desferal 500 mg injection | ৳ 258.11 | N/A |
Description
Overview of the medicine
Deferoxamine is an iron-chelating agent used to remove excess iron from the body. It forms stable complexes with iron ions, which are then excreted, preventing organ damage from iron overload. It also chelates aluminum.
Uses & Indications
Dosage
Adults
Chronic iron overload: Typically 20-40 mg/kg/day via SC infusion over 8-12 hours, 5-7 times per week. IV infusion or IM injection also possible. Acute iron poisoning: 15 mg/kg/hour IV infusion, reducing as needed. Max 80 mg/kg/24 hours.
Elderly
Use with caution, often starting at lower doses, monitoring renal function.
Renal_impairment
Dosage reduction may be required, close monitoring of iron excretion and deferoxamine levels. Contraindicated in severe renal impairment.
How to Take
Reconstitute the 500 mg vial with 5 mL of sterile water for injection. Administer via slow subcutaneous infusion, intravenous infusion, or intramuscular injection as prescribed. Avoid rapid intravenous bolus.
Mechanism of Action
Deferoxamine binds to ferric iron (Fe3+) in the bloodstream, tissues, and cells, forming a stable, non-toxic complex (ferrioxamine) that is readily excreted, primarily via the kidneys. It also chelates aluminum.
Pharmacokinetics
Onset
Rapid after IV administration (within minutes), slower with SC/IM (within hours).
Excretion
Mainly renal (ferrioxamine complex), some biliary.
Half life
Plasma half-life is short (approx. 20-30 minutes for parent drug). Excreted complex has a longer effective half-life.
Absorption
Poorly absorbed orally. Well absorbed after subcutaneous (SC) or intramuscular (IM) administration. IV administration bypasses absorption.
Metabolism
Primarily metabolized by plasma enzymes (esterases) into inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to deferoxamine or any component of the formulation.
- Severe renal disease or anuria.
Drug Interactions
Gallium-67
May interfere with gallium-67 imaging results.
Prochlorperazine
May cause transient loss of consciousness (neurological symptoms).
Vitamin C (Ascorbic Acid)
Concurrent use, especially at high doses or in patients with cardiac dysfunction, may lead to enhanced iron toxicity and cardiac decompensation. Vitamin C should only be given if iron overload is well-controlled and separately from deferoxamine administration.
Storage
Store dry powder below 25°C (77°F). Protect from moisture. Keep out of reach of children.
Overdose
Symptoms include hypotension, tachycardia, shock, acute renal failure, and respiratory distress. Management involves supportive care, fluid resuscitation, and discontinuation of deferoxamine. Hemodialysis may be considered.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if deferoxamine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to deferoxamine or any component of the formulation.
- Severe renal disease or anuria.
Drug Interactions
Gallium-67
May interfere with gallium-67 imaging results.
Prochlorperazine
May cause transient loss of consciousness (neurological symptoms).
Vitamin C (Ascorbic Acid)
Concurrent use, especially at high doses or in patients with cardiac dysfunction, may lead to enhanced iron toxicity and cardiac decompensation. Vitamin C should only be given if iron overload is well-controlled and separately from deferoxamine administration.
Storage
Store dry powder below 25°C (77°F). Protect from moisture. Keep out of reach of children.
Overdose
Symptoms include hypotension, tachycardia, shock, acute renal failure, and respiratory distress. Management involves supportive care, fluid resuscitation, and discontinuation of deferoxamine. Hemodialysis may be considered.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if deferoxamine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from manufacturing date for unopened vials. Reconstituted solution is stable for 24 hours at room temperature.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Off-patent (generic versions available)
WHO Essential Medicine
YesClinical Trials
Ongoing research to optimize dosing, administration routes, and combination therapies for iron overload. Studies also focus on long-term outcomes and safety profiles.
Lab Monitoring
- Serum ferritin levels (monthly/quarterly).
- Iron excretion (24-hour urine iron excretion).
- Renal function (creatinine, BUN).
- Liver function tests.
- Ocular examinations (slit lamp, ophthalmoscopy) at baseline and every 3-6 months.
- Auditory examinations (audiometry) at baseline and every 3-6 months.
- Growth in children.
Doctor Notes
- Monitor cardiac function closely in patients with existing heart disease receiving high doses of deferoxamine or concurrent Vitamin C.
- Regular ophthalmological and audiological exams are crucial due to potential toxicity.
- Assess renal function before and during treatment.
- Educate patients on proper injection technique and site rotation.
Patient Guidelines
- Administer the injection exactly as prescribed by your doctor.
- Report any vision or hearing changes immediately.
- Monitor for injection site reactions and report severe ones.
- Maintain proper hydration.
- Do not take high doses of Vitamin C without medical advice.
Missed Dose Advice
If a scheduled dose is missed, administer it as soon as remembered. If it's almost time for the next dose, skip the missed dose and resume the regular schedule. Do not double the dose. Consult your doctor.
Driving Precautions
Deferoxamine may cause visual or hearing disturbances, which could impair the ability to drive or operate machinery. Patients should be cautious until they know how the drug affects them.
Lifestyle Advice
- Maintain a balanced diet and regular exercise. Avoid alcohol if it exacerbates underlying conditions.
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