deferoxamin

Deferoxamine, also known as desferrioxamine, is an iron chelating agent used to treat iron overload and acute iron poisoning. It binds ferric iron (Fe3+) with high affinity, forming ferrioxamine complexes that are water soluble and primarily excreted by the kidneys.

Mechanism of action is based on chelation: deferoxamine acts as a hexadentate chelator, sequestering iron that has accumulated in body tissues or entered the circulation after overdose. The resulting ferrioxamine complex is more readily excreted, reducing iron burden and mitigating toxic effects.

Medical uses include treatment of acute iron poisoning, especially in children, and management of chronic iron overload in patients who require regular transfusions, such as those with thalassemia or other severe anemias. It may be used as part of a chelation strategy in complex cases, sometimes in combination with other agents, under specialist supervision.

Administration and dosing are determined by clinical indication and patient factors. Deferoxamine is given by intravenous or subcutaneous infusion, often with careful monitoring. Rapid intravenous administration can cause hypotension, so infusions are typically controlled and timed. Treatment requires regular monitoring of iron load, organ function, and potential adverse effects.

Adverse effects can include infusion-site reactions, fever, rash, and hypotension with rapid infusion. Long-term use has been associated with auditory and ophthalmologic changes in some patients, and other systemic effects may occur. Use is guided by clinical need and monitored by healthcare professionals.

Deferoxamine remains one of the primary agents for iron chelation and is distinguished from other chelators such as deferiprone and deferasirox by its pharmacokinetic profile and routes of administration.