Deferoxamine Mesylate for Injection

DEFETIV for Injection is a chelating agent used to treat acute and chronic iron overload, as well as aluminum toxicity. It works by binding to excess iron or aluminum in the body, allowing these metals to be excreted. Here are the primary uses of Deferoxamine Mesylate for Injection:

1. Treatment of Chronic Iron Overload

   - Thalassemia and Sickle Cell Disease: Deferoxamine is used in patients with chronic iron overload due to frequent blood transfusions, such as those with thalassemia major, sickle cell disease, or other chronic anemias. It helps to prevent the accumulation of iron in vital organs, such as the heart and liver, which can lead to organ damage.

   - Hereditary Hemochromatosis: It can also be used in cases of hereditary hemochromatosis where phlebotomy (blood removal) is not possible or sufficient to reduce iron levels.

2. Treatment of Acute Iron Poisoning

   - Iron Toxicity in Children: Deferoxamine is used in cases of acute iron poisoning, particularly in children who have ingested a large amount of iron-containing supplements. It binds to free iron in the bloodstream, forming a complex that is excreted in the urine.

   - Severe Iron Overdose: In cases of severe iron overdose, where life-threatening symptoms such as shock, metabolic acidosis, or coma are present, Deferoxamine is administered to rapidly reduce iron levels.

 3. Treatment of Aluminum Toxicity

   - Chronic Kidney Disease (CKD) : Deferoxamine is used in patients with CKD who are undergoing dialysis and have aluminum toxicity due to exposure to aluminum-containing dialysate or medications. Aluminum accumulation can lead to bone disease (osteomalacia) and encephalopathy, and Deferoxamine helps to reduce aluminum levels in these patients.

Mechanism of Action

Deferoxamine binds to free iron and aluminum ions in the body to form stable, water-soluble complexes. These complexes are then excreted by the kidneys, reducing the levels of free iron or aluminum and preventing toxicity. The iron complex is called ferrioxamine, and the aluminum complex is called aluminoxamine.

Important Considerations

- Side Effects : Common side effects include injection site reactions, hypotension (if administered too quickly), gastrointestinal symptoms, and allergic reactions. Long-term use can lead to visual and auditory disturbances, growth retardation in children, and lung complications.

- Administration: Deferoxamine is administered intramuscularly, subcutaneously, or intravenously. The route and dosage depend on the condition being treated, the severity of iron or aluminum overload, and the patient's overall health.

- Monitoring: Regular monitoring of iron levels (serum ferritin), aluminum levels, kidney function, and hearing and vision is necessary during treatment with Deferoxamine. Growth monitoring is important in pediatric patients receiving long-term therapy.

- Contraindications and Cautions: Deferoxamine is contraindicated in patients with severe renal impairment who cannot excrete the drug. Caution is needed in patients with underlying lung disease or visual and auditory conditions.

- Drug Interactions: Concurrent use with vitamin C should be done cautiously, as it can increase the risk of iron toxicity by mobilizing iron from tissues. Deferoxamine should not be used with other chelating agents without careful medical supervision.

Clinical Advantages

- Effective Iron Chelation: Deferoxamine remains one of the most effective agents for reducing iron overload in patients receiving frequent blood transfusions.

- Life-Saving in Iron Poisoning: In acute iron poisoning, especially in pediatric cases, Deferoxamine can be life-saving by rapidly binding and removing toxic levels of iron.

- Reduction of Aluminum Toxicity in CKD: It plays a crucial role in preventing and treating aluminum toxicity in patients with CKD, improving quality of life and reducing complications related to bone and neurological health.

Deferoxamine Mesylate for Injection is a vital medication in managing conditions associated with iron and aluminum overload. Its ability to chelate and remove excess metals from the body makes it an essential tool in preventing the long-term complications associated with these conditions, although its use requires careful monitoring due to potential side effects and complications.