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|Deferoxamine

DEFEROXAMINE (Systemic)

Some commonly used brand names are:

In the U.S.—

• Desferal

In Canada—

• Desferal

Another commonly used name is desferrioxamine .

Category

• Chelating agent

Description

Deferoxamine (dee-fer-OX-a-meen) is used to remove excess iron from the body. This may be necessary in certain patients with anemia who must receive many blood transfusions. It is also used to treat acute iron poisoning, especially in small children.

Deferoxamine combines with iron in the bloodstream. The combination of iron and deferoxamine is then removed from the body by the kidneys. By removing the excess iron, the medicine lessens damage to various organs and tissues of the body. This medicine may be used for other conditions as determined by your doctor.

Deferoxamine is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

• Parenteral
• Injection (U.S. and Canada)

Before Receiving This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For deferoxamine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to deferoxamine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Deferoxamine has not been shown to cause birth defects or other problems in humans. However, in animal studies this medicine caused birth defects when given in doses just above the recommended human dose. In general, deferoxamine is not recommended for women who may become pregnant or for use during early pregnancy, unless the woman"s life is in danger from too much iron.

Breast-feeding—It is not known whether deferoxamine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Deferoxamine is not used for long-term treatment of children up to 3 years of age. Also, younger patients are more likely to develop hearing and vision problems with the use of deferoxamine in high doses for a long time.

Older adults—The combination of deferoxamine and vitamin C should be used with caution in older patients, since this combination may be more likely to cause heart problems in these patients than in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving deferoxamine, it is especially important that your health care professional know if you are taking the following:

• Ascorbic acid (vitamin C)—Use with deferoxamine may be harmful to body tissues, especially in the elderly

Other medical problems—The presence of other medical problems may affect the use of deferoxamine. Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease—Patients with kidney disease may be more likely to have side effects

Proper Use of This Medicine

Deferoxamine may sometimes be given at home to patients who do not need to be in the hospital. If you are receiving this medicine at home, make sure you clearly understand and carefully follow your doctor"s instructions .

Dosing—The dose of deferoxamine will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of deferoxamine. If your dose is different, do not change it unless your doctor tells you to do so.

• For injection dosage form:
  • For acute iron toxicity:
    • Adults and children over 3 years of age—Dose is based on body weight and must be determined by your doctor. The usual dose is 90 milligrams (mg) per kilogram (kg) (41 mg per pound) of body weight, followed by 45 mg per kg (20 mg per pound) of body weight, injected into a muscle every four to twelve hours. If it is injected into a vein, the usual dose is 15 mg per kg (7 mg per pound) of body weight per hour every eight hours.
    • Children up to 3 years of age—The usual dose is 15 mg per kg (7 mg per pound) of body weight per hour, injected into a vein.
  • For chronic iron toxicity:
    • Adults and children over 3 years of age—The usual dose is 500 mg to 1 gram a day, injected into a muscle. Or, the medicine may be injected under the skin by an infusion pump. The usual dose is 1 to 2 grams (20 to 40 mg per kg [9 to 18 mg per pound] of body weight) a day, injected under the skin, over a period of eight to twenty-four hours. If you are receiving blood transfusions, the usual dose is 500 mg to 1 gram a day, injected into a muscle. An extra 2 grams of the medicine is injected into a vein with each unit of blood at a rate of 15 mg per kg of body weight per hour.
    • Children up to 3 years of age—Use and dose must be determined by your doctor. The usual dose is 10 mg per kg (5 mg per pound) of body weight a day, injected under the skin.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Store the mixed medicine at room temperature for no longer than recommended by your doctor or the manufacturer. Do not refrigerate.
• Do not keep outdated medicine or medicine that is no longer needed. Be sure any discarded medicine is out of the reach of children.

Precautions While Receiving This Medicine

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to prevent unwanted effects. Certain blood and urine tests must be done regularly to check for the need for dosage changes.

Deferoxamine may cause some people, especially younger patients, to have hearing and vision problems within a few weeks after they start taking it. If you notice any problems with your vision, such as blurred vision, difficulty in seeing at night, or difficulty in seeing colors, or difficulty with your hearing, check with your doctor as soon as possible . The dose of deferoxamine may need to be adjusted.

Do not take vitamin C unless your doctor has told you to do so.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Hearing and vision problems are more likely to occur in younger patients taking high doses and on long-term treatment.

Deferoxamine may cause the urine to turn orange-rose in color. This is to be expected while you are using this medicine.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, deferoxamine is used in certain patients with the following medical condition:

• Aluminum toxicity (too much aluminum in the body)

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.

Revised: 06/22/2000

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