How it is administered

Deferoxamine is available as a sterile, lyophilized powder for injection. It can be administered in the following ways:

• Intramuscular injection
• Subcutaneous infusion (often using a portable infusion pump)
• Intravenous infusion (for certain urgent situations)

The medication is supplied in vials containing either 500 mg or 2 grams. It must be reconstituted with sterile water before use. The specific route, dose, and frequency depend on the patient's condition and the severity of iron overload.

How it works

Deferoxamine is an iron-chelating agent. This means it works by binding to excess iron in the body, forming a stable complex that can then be safely excreted, mainly through the kidneys (urine) and to a lesser extent through the bile (feces).

Deferoxamine is particularly effective at removing iron from storage sites in the body, such as ferritin and hemosiderin, but it does not remove iron from hemoglobin or cytochromes. By reducing iron overload, deferoxamine helps prevent damage to organs such as the heart and liver, which can occur when iron accumulates due to frequent blood transfusions—a common issue in patients with chronic anemias, including those with myelodysplastic syndromes (MDS).

The medication does not increase the excretion of other important minerals or electrolytes, making it a targeted therapy for iron overload.

Who Should take it

Deferoxamine is indicated for:

• Treatment of transfusional iron overload in patients with chronic anemia, such as those with myelodysplastic syndromes (MDS), thalassemia, or other conditions requiring frequent blood transfusions.
• As an adjunct to standard measures for the treatment of acute iron intoxication (iron poisoning).

In patients with MDS, frequent transfusions can lead to iron buildup, which can damage organs over time. Deferoxamine is used to help manage and prevent complications from this iron overload, improving quality of life and reducing the risk of organ damage.

Who should not take it

Deferoxamine should NOT be used in:

• Patients with a known hypersensitivity (allergy) to deferoxamine or any of its ingredients. Reactions can include anaphylaxis (a severe allergic reaction).
• Patients with severe renal disease or anuria (the inability to produce urine), since both the drug and the iron complex are primarily removed from the body by the kidneys.

Caution is also advised in pregnant women, as animal studies show potential harm to the fetus. It should not be used in patients with primary hemochromatosis (a different type of iron overload), as phlebotomy (blood removal) is the preferred treatment for that condition.

Commonly used with

Deferoxamine may be used together with vitamin C (ascorbic acid) in some patients. Vitamin C can help increase the availability of iron for chelation, but it should only be started after at least one month of regular deferoxamine therapy and at recommended doses, as high doses can increase the risk of heart problems.

It is also commonly used alongside ongoing blood transfusions in patients with chronic anemia, such as those with myelodysplastic syndromes.

Commonly tested with

Deferoxamine has been tested in combination with vitamin C in clinical settings, as vitamin C can enhance iron excretion. However, vitamin C should be used cautiously and only under medical supervision.

It has also been studied in the context of supportive care for patients receiving frequent transfusions for chronic anemias, including myelodysplastic syndromes and thalassemia, to manage iron overload.