Deferoksamin

Deferoksamin, also known as deferoxamine, is an iron chelating agent used to treat systemic iron overload and acute iron poisoning. It binds ferric iron (Fe3+) to form a ferrioxamine complex, which is water-soluble and excreted in the urine, helping to reduce excess body iron.

Medical uses include treatment of acute iron poisoning and chronic iron overload caused by repeated transfusions, such as in thalassemia or other severe anemias. Because oral absorption of deferoxamine is poor, it is given by parenteral administration, typically as a slow intravenous infusion or subcutaneous infusion with an infusion pump. The dose and duration are guided by the level of iron burden and clinical response, with monitoring of ferritin, liver iron concentration, renal function, and signs of toxicity.

Mechanism and pharmacology: Deferoxamine is a hexadentate chelator that binds Fe3+ with high affinity, forming ferrioxamine. The complex is water-soluble and readily excreted by the kidneys, reducing free iron available to catalyze harmful free radical reactions.

Adverse effects and safety: Common issues include infusion-site reactions, hypotension or tachycardia during administration, and hypersensitivity reactions. Urine can take on a pink or orange color due to ferrioxamine excretion. Long-term high-dose therapy may be associated with ototoxicity and vision changes; caution is advised in patients with renal impairment.

History and availability: Deferoxamine was developed in the 20th century and has become a mainstay of iron chelation therapy, now available in generic forms. In chronic iron overload, it is sometimes used in combination with newer oral chelators.

See also: deferasirox, deferiprone.