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.

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.

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.