Deferoksamina

Deferoksamina, commonly referred to as deferoxamine in many regions, is an iron chelating agent used to treat iron overload and acute iron poisoning. It works by binding ferric iron (Fe3+) to form a water-soluble complex that is excreted primarily by the kidneys, thereby reducing body iron burden.

Indications for deferoksamina include management of acute iron intoxication following ingestion of iron-containing products and chronic iron overload due to repeated transfusions, such as in certain anemias. It is particularly valuable when phlebotomy is not feasible or effective. It is not used to treat other metal overloads or mineral deficiencies unless specifically indicated.

Administration and pharmacokinetics are guided by the clinical situation. Deferoksamina is not orally active and is given by intramuscular or intravenous infusion, often as a slow continuous or intermittent infusion over several hours. Dosing is individualized based on body weight, iron load, and response, with monitoring of laboratory markers such as ferritin and transferrin saturation, along with clinical assessment.

Safety and adverse effects are a consideration with any chelation therapy. Common issues include infusion-site reactions, fever, and hypersensitivity. Rapid IV administration can cause hypotension or tachycardia. Long-term use carries a risk of ototoxicity and optic neuropathy, and there may be urine discoloration due to ferrioxamine excretion. Other potential effects include hepatic enzyme changes and allergic reactions. Monitoring for hearing, vision, liver function, and iron parameters is recommended during therapy.

See also: deferiprone, deferasirox.