Desferrioxamine Mesilate

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Generic Name of Desferrioxamine Mesilate - Learn More

Desferrioxamine Mesilate

Desferrioxamine Mesilate Precaution - What You Need to Know

Desferrioxamine mesilate is a chelating agent primarily used to treat iron overload conditions, such as thalassemia major, by binding excess iron and facilitating its excretion via the urine. When using desferrioxamine, caution is necessary in patients with pre-existing kidney or liver disease, as these organs are essential for the metabolism and elimination of the drug. Patients with impaired renal function are at a higher risk of developing nephrotoxicity due to the accumulation of the chelator or its metabolites. Additionally, desferrioxamine can cause ocular toxicity, and patients should be monitored regularly for any signs of visual disturbances, particularly if they are on long-term therapy. Desferrioxamine should be used cautiously in patients with a history of hearing loss, as it can also cause ototoxicity, leading to hearing impairment or tinnitus. It is contraindicated during pregnancy, particularly during the first trimester, as it may harm the developing fetus. It is also excreted in breast milk, and its use in breastfeeding mothers should be avoided unless necessary. Patients undergoing desferrioxamine therapy should be closely monitored for signs of iron toxicity and adverse effects, particularly visual and auditory impairments, and any signs of hypersensitivity or allergic reactions.

Desferrioxamine Mesilate Indication - Uses and Benefits

Desferrioxamine mesilate is primarily used for the treatment of chronic iron overload, which typically results from repeated blood transfusions in conditions such as thalassemia major, sickle cell disease, and myelodysplastic syndromes. Chronic transfusion therapy can lead to iron accumulation in various organs, including the liver, heart, and endocrine organs, causing serious complications like liver cirrhosis, heart failure, and diabetes. Desferrioxamine works by binding excess iron and promoting its excretion through the kidneys, thus reducing the iron burden in the body. It is particularly useful when oral iron chelators, such as deferasirox or deferiprone, are not effective or not well tolerated. Desferrioxamine is often administered through subcutaneous or intravenous routes, depending on the patient's condition and response to therapy. Off-label, desferrioxamine may also be used for iron overload from other sources, such as hemochromatosis or acute iron toxicity due to poisoning, though it is less commonly used in these contexts due to the availability of other chelation therapies. It has also been investigated in the treatment of aluminum toxicity in patients on long-term dialysis.

Desferrioxamine Mesilate Contraindications - Important Warnings

Desferrioxamine is contraindicated in patients with known hypersensitivity to the drug or its components, as it can cause severe allergic reactions such as rash, anaphylaxis, or hypotension. It should also be avoided in individuals with pre-existing kidney disease, particularly in those with severe renal insufficiency (creatinine clearance less than 30 mL/min), because of the increased risk of nephrotoxicity due to impaired elimination of the drug. It is contraindicated in patients with severe hepatic impairment due to the potential for further liver damage and exacerbation of liver dysfunction. Desferrioxamine should not be used during pregnancy, particularly in the first trimester, unless the potential benefits outweigh the risks, as it may cause fetal harm, including developmental abnormalities. It is also contraindicated in breastfeeding women, as the drug is excreted in breast milk and may affect the infant. Desferrioxamine should not be used in patients with impaired hearing or those with a history of hearing loss, as it can cause ototoxicity, resulting in permanent hearing damage if not closely monitored.

Desferrioxamine Mesilate Side Effects - What to Expect

The most common side effects of desferrioxamine mesilate are related to its infusion, particularly during long-term therapy. These include local reactions at the infusion site, such as pain, redness, and swelling, which are generally mild and transient. Other frequent side effects include gastrointestinal issues, including nausea, vomiting, and abdominal discomfort. Serious, but less common, side effects include nephrotoxicity and hepatotoxicity, particularly when used in patients with pre-existing kidney or liver conditions. Desferrioxamine is also associated with auditory and ocular toxicity; prolonged use may result in hearing loss (ototoxicity), which can be permanent, and visual disturbances, including retinopathy and maculopathy, particularly with high doses. Regular monitoring of auditory and visual functions is recommended during treatment to prevent irreversible damage. Hypersensitivity reactions, such as rash, anaphylaxis, and hypotension, can occur, and any signs of allergic reactions should prompt immediate discontinuation of the drug. Additionally, desferrioxamine has been associated with a potential risk of growth retardation in children, although this is less common with appropriate monitoring and dose adjustments. Rare but severe side effects include arrhythmias, including those related to heart failure in patients with significant iron overload, and secondary infections due to long-term use. Prompt intervention is necessary if any serious adverse effects are noted.

Desferrioxamine Mesilate Pregnancy Category ID - Safety Information

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Desferrioxamine Mesilate Mode of Action - How It Works

Desferrioxamine mesilate functions as a chelating agent, specifically binding to free ferric iron (Fe3+) in the body. Once bound to iron, the resulting complex is excreted primarily via the kidneys in urine. By removing excess iron from the body, desferrioxamine prevents iron accumulation in organs, such as the liver, heart, and endocrine glands, which can otherwise lead to tissue damage and organ dysfunction due to oxidative stress. This process reduces the risk of complications like heart failure, liver cirrhosis, and diabetes, which are common in patients with iron overload. Desferrioxamine has a high affinity for ferric iron, and the binding process is dose-dependent, meaning the drug’s effectiveness increases with higher doses. It does not bind to other essential metals like zinc or copper to a significant extent, making it relatively selective for iron. The chelation therapy offered by desferrioxamine is crucial in preventing the adverse effects of chronic iron overload, particularly in patients who are dependent on blood transfusions for managing their underlying conditions.

Desferrioxamine Mesilate Drug Interactions - What to Avoid

Desferrioxamine interacts with several medications and substances, which can alter its effectiveness or lead to additional risks. Co-administration with other chelating agents, such as deferoxamine or deferasirox, should be avoided unless under strict medical supervision, as this could lead to an increased risk of iron depletion and potential toxicity. The use of desferrioxamine in combination with drugs that affect renal function (e.g., nonsteroidal anti-inflammatory drugs (NSAIDs) or certain diuretics) should be done cautiously, as it may increase the risk of nephrotoxicity. Desferrioxamine can also interact with aluminum-containing medications, such as antacids, increasing the risk of aluminum toxicity, especially in patients undergoing chronic dialysis. Alcohol use should be limited or avoided, as it can exacerbate liver toxicity when combined with desferrioxamine. There is also the potential for synergistic toxic effects if desferrioxamine is combined with drugs known to cause ototoxicity, such as aminoglycoside antibiotics (e.g., gentamicin), increasing the risk of hearing impairment. Monitoring and dose adjustments may be required when desferrioxamine is co-administered with other drugs that influence iron metabolism or renal and hepatic function.

Desferrioxamine Mesilate Adult Dose - Recommended Dosage

For the treatment of chronic iron overload due to conditions such as thalassemia major, the typical adult dose of desferrioxamine mesilate is 20–40 mg/kg/day, administered via subcutaneous infusion or intravenous infusion. The duration of treatment varies depending on the severity of the iron overload and the patient's response to therapy. The infusion is generally administered over 8–12 hours per day, with the frequency adjusted based on the patient’s iron levels, response, and tolerance to the drug. In some cases, particularly when a more rapid reduction in iron levels is needed, higher doses of up to 60 mg/kg/day may be used. For acute iron poisoning, higher doses of desferrioxamine (up to 15 mg/kg/hour) may be administered intravenously for rapid removal of excess iron. The maximum dose should not exceed 100 mg/kg/day, and the treatment duration should be tailored to the individual patient, with regular monitoring of serum ferritin levels, kidney and liver function, and auditory and visual health.

Desferrioxamine Mesilate Child Dose - Dosage for Children

For children, the typical dose of desferrioxamine mesilate for chronic iron overload is 20–40 mg/kg/day, administered via subcutaneous or intravenous infusion. The dose should be adjusted based on the child’s weight, clinical response, and iron levels. In some cases, doses up to 60 mg/kg/day may be used for more severe iron overload, but the dose should be carefully titrated to minimize side effects, particularly ototoxicity and visual disturbances. Desferrioxamine therapy in children should be accompanied by regular monitoring of growth parameters, liver function, kidney function, and auditory and visual health. Because of the risk of ototoxicity, hearing assessments should be performed periodically throughout treatment. Additionally, the use of desferrioxamine in children with severe renal or hepatic impairment should be avoided unless absolutely necessary, and any signs of toxicity should prompt dose reduction or discontinuation.

Desferrioxamine Mesilate Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, desferrioxamine should be used with caution. As the drug is primarily eliminated through the kidneys, renal dysfunction can lead to drug accumulation and an increased risk of toxicity, particularly nephrotoxicity. For patients with mild to moderate renal impairment, the usual dose of desferrioxamine may be continued, but renal function should be closely monitored. In cases of severe renal dysfunction, dose reduction or discontinuation may be required, and the drug should not be used in patients with severe renal insufficiency (creatinine clearance less than 30 mL/min) unless the benefits outweigh the risks. During therapy, patients should be monitored regularly for signs of renal toxicity, including elevated serum creatinine and decreased urine output. For patients undergoing dialysis, desferrioxamine should be administered after dialysis sessions, as the drug may be removed during the dialysis process.