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Pharmacologic effect.
Complexing compound. Forms complexes mainly with trivalent iron and aluminum ions; to a lesser extent binds divalent ions. Deferoxamine can bind iron, which is in free form or is part of ferritin and hemosiderin, and also bind aluminum, which is in the tissues. The resulting compounds are excreted in the urine, which leads to a decrease in the pathological deposits of iron and aluminum in the tissues.
Indications.
Transfusion hemosiderosis (especially with thalassemia and other chronic anemias). Acute poisoning with iron preparations (as part of combination therapy). Conduct a diagnostic test to determine the pathological deposits of iron or aluminum.
Dosing regimen.
The exact dose and mode of administration are determined individually, and the dose needs to be reviewed during therapy. For most patients, the daily dose is 20-40 mg / kg body weight. Higher doses should be used only if the expected positive result exceeds the potential risk associated with unwanted side effects.
In case of acute poisoning with iron preparations, intently given in the initial dose of 1 g. If necessary, repeated injections are possible, with a daily dose not exceeding 6 g. intravenous injection in the same doses (slow infusion) is used only in the case of a patient’s serious condition (collapse).
Side effect.
From the side of the central nervous system: dizziness, convulsions; when used in high doses and / or long-term treatment, visual acuity, peripheral and twilight vision disorders, color perception disorders, cataract development, hearing loss (in the high frequency range) are possible.
On the part of the digestive system: diarrhea, diarrhea, liver dysfunction.
From the cardiovascular system: arterial hypotension, collapse.
Other: allergic skin reactions, renal dysfunction, thrombocytopenia.
Contraindications.
I trimester of pregnancy, hypersensitivity to deferoxamine.
Pregnancy and lactation.
Contraindicated in the first trimester of pregnancy. When using deferoxamine during lactation, breastfeeding should be discontinued.
Application for violations of kidney function.
With caution apply in patients with severe renal failure, withdrawal of deferoxamine with iron in these patients can be increased by hemodialysis.