Deferoxamine Mesylate
**Deferoxamine mesylate** is a highly specific **iron-chelating agent** primarily utilized in veterinary medicine as a life-saving antidote for acute iron toxicosis (e.g., ingestion of iron supplements or oxygen absorbers). It is also occasionally evaluated for aluminum toxicity and as an adjunctive treatment for acute cardiac ischemia, though its efficacy for reperfusion injury has been disappointing. Key clinical points: * **High Affinity**: It specifically targets and binds free iron in the bloodstream and tissues, preventing iron-induced oxidative damage. * **Urine Discoloration**: A hallmark of successful chelation is the production of a salmon-pink or 'vin rosé' colored urine, indicating the excretion of the iron-chelate complex. * **Administration**: It must be given parenterally (usually IM or slow IV CRI). Oral administration is generally contraindicated as it may paradoxically increase gastrointestinal iron absorption.
Mecanismo: Deferoxamine acts by directly binding to free iron to neutralize its toxicity: * The drug possesses three hydroxamic groups that have a high affinity for **ferric (Fe³⁺) ions**. * Deferoxamine + Fe³⁺ → **Ferrioxamine** (a stable, water-soluble chelate complex). * By sequestering the iron, it prevents the metal from participating in the **Fenton reaction**, thereby halting the production of damaging reactive oxygen species (hydroxyl radicals). * The ferrioxamine complex is then readily excreted by the kidneys into the urine. It does not significantly chelate other essential trace metals or electrolytes (except aluminum).
Dosificación por especie
- Severe iron toxicosis · 40 mg/kg IM q4-8 hours · IM · q4-8h · Until urine clears or serum iron levels return to normal · Cat dosages are not well established; extrapolated from general animal doses.
- Severe iron toxicosis · 15 mg/kg/hour · IV · CRI · 2-3 days · Cat dosages are not well established; extrapolated from general animal doses.
- Severe iron toxicosis · 10 mg/kg IM or IV q8h for 24 hours · IM/IV · q8h · 24 hours · Cat dosages are not well established.
- Severe iron toxicosis · 40 mg/kg IM q4-8 hours · IM · q4-8h · Until urine clears or serum iron levels return to normal · Most effective within the first 24 hours. IM route is preferred as too rapid IV administration can cause hypotension and pulmonary edema.
- Severe iron toxicosis · 15 mg/kg/hour · IV · CRI · 2-3 days (until serum iron < 300 microliters/dL or below TIBC) · Initiate ASAP or at least within 12 hours of ingestion. Give as a constant rate infusion. If CRI not possible, give 40 mg/kg IM q4-8h.
- Severe iron toxicosis · 10 mg/kg IM or IV q8h for 24 hours · IM/IV · q8h · 24 hours
- Ferric ion chelator during treatment of cardiac arrest (experimental) · 5-15 mg/kg IV , IM or SC · IV/IM/SC · Single dose or as directed
- Ferric ion chelator during treatment of cardiac arrest (experimental) · 10 mg/kg IV , IM q2h twice, then three times daily for 24 hours · IV/IM · q2h twice, then TID · 24 hours
Las dosis son una referencia clínica para médicos veterinarios. Confirme siempre con la información vigente del producto y el paciente individual.
Vías de administración
Contraindicaciones
- Severe renal failure (unless dialysis is used to remove the ferrioxamine complex)
Efectos adversos
- Allergic reactions (hives, wheezing)
- Auditory neurotoxicity (with chronic, high-dose therapy)
- Pain or swelling at injection sites
- Gastrointestinal distress
- Hypotension, tachycardia, and convulsions (if given IV too rapidly)
- Pulmonary edema (associated with rapid IV administration)
Interacciones farmacológicas
- Prochlorperazine · Concurrent use may cause temporary impairment of consciousness.
- Vitamin C (Ascorbic Acid) · May be synergistic in removing iron, but could lead to increased tissue iron toxicity, especially in cardiac muscle. Use with extreme caution in patients with preexisting cardiac disease.
Monitoreo
- Serum iron levels
- Total iron-binding capacity (TIBC)
- Serum ferritin
- Urine color (monitor for clearing of the 'vin rosé' color)
- Blood pressure and heart rate (especially during IV infusion)
- Ophthalmic examinations (if used chronically)
Sobredosis
Acute overdosage or excessively rapid IV administration can lead to severe hypotension, tachycardia, convulsions, hives, wheezing, and pulmonary edema. Chronic high-dose use may lead to hypocalcemia, thrombocytopenia, and auditory/visual neurotoxicity. Treatment is supportive and symptomatic.
La referencia de fármacos de VetSheet está destinada a médicos veterinarios como apoyo a la decisión clínica; no sustituye el juicio profesional ni la información vigente del fabricante.