去鐵胺甲磺酸鹽
Deferoxamine Mesylate
Deferoxamine mesylate
別名: Desferal · DFO · desferoxamine mesylate · Ba-33112 · Ba-29837 · deferoxamini mesilas · desferrioxamine mesylate · desferrioxamine methanesulphonate · NSC-527604 · Desferin
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Severe iron toxicosis | 40 mg/kg IM q4-8 hours | IM | q4-8h | Until urine clears or serum iron levels return to normal | 🌎 NA |
| Severe iron toxicosis | 15 mg/kg/hour | IV | CRI | 2-3 days (until serum iron < 300 microliters/dL or below TIBC) | 🌎 NA |
| Severe iron toxicosis | 10 mg/kg IM or IV q8h for 24 hours | IM/IV | q8h | 24 hours | 🌎 NA |
| 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 | — | 🌎 NA |
| 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 | 🌎 NA |
- Severe iron toxicosis: 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: 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Severe iron toxicosis | 40 mg/kg IM q4-8 hours | IM | q4-8h | Until urine clears or serum iron levels return to normal | 🌎 NA |
| Severe iron toxicosis | 15 mg/kg/hour | IV | CRI | 2-3 days | 🌎 NA |
| Severe iron toxicosis | 10 mg/kg IM or IV q8h for 24 hours | IM/IV | q8h | 24 hours | 🌎 NA |
- Severe iron toxicosis: Cat dosages are not well established; extrapolated from general animal doses.
- Severe iron toxicosis: Cat dosages are not well established; extrapolated from general animal doses.
- Severe iron toxicosis: Cat dosages are not well established.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
去鐵胺 (Deferoxamine mesylate) 是一種高度專一的鐵螯合劑，在獸醫學中主要作為急性鐵中毒（例如誤食鐵劑補充品或脫氧劑）的救命解毒劑。它偶爾也被用於評估治療鋁中毒及作為急性心肌缺血的輔助治療，但其在再灌注損傷的療效並不理想。
主要臨床重點：
- 高親和力：能特異性地標靶並結合血液與組織中的游離鐵，防止鐵引發的氧化損傷。
- 尿液變色：成功螯合的標誌是產生鮭魚粉色或「玫瑰紅 (vin rosé)」色的尿液，這表示鐵-螯合物複合物正在被排出。
- 給藥方式：必須以腸胃外途徑給藥（通常為肌肉注射或緩慢靜脈連續輸注）。一般禁忌口服給藥，因為這可能會反常地增加胃腸道對鐵的吸收。
作用機制
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).
安全性與警告
禁忌症
- Severe renal failure (unless dialysis is used to remove the ferrioxamine complex)
不良反應
- 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)
注意事項
WARNING: Intravenous administration must be performed slowly (preferably via Constant Rate Infusion). Too rapid IV injection can precipitate severe hypotension, arrhythmias, and shock.
- Pregnancy: FDA Category C. Has caused skeletal abnormalities in animals at doses just above those recommended for iron toxicity. Use only when benefits outweigh risks.
- Oral Use: Oral administration is controversial and generally not recommended, as it may increase the amount of iron absorbed from the gut.
- Laboratory Interference: May cause falsely low values on colorimetric iron assays and falsely high Total Iron Binding Capacity (TIBC) measurements.
藥物相互作用
Concurrent use may cause temporary impairment of consciousness.
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.
監測
- 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)
藥物動力學
吸收
Poorly absorbed from the gastrointestinal tract; must be given parenterally for systemic effect.
分佈
Widely distributed throughout the body.
代謝
Binds with free iron to form the stable complex ferrioxamine.
排除
Deferoxamine and the ferrioxamine complex are excreted primarily in the urine.
過量
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.
可用產品
劑型
- Powder for Injection (lyophilized): 500 mg
- Powder for Injection (lyophilized): 2 g
人用標示
- Deferoxamine Mesylate Powder for Injection (lyophilized): 500 mg & 2 g in vials (Desferal®, generic)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store intact vials at room temperature. After aseptic reconstitution with sterile water for injection, the solution may be stored for up to 24 hours at room temperature and should be protected from light. Do not mix with other drugs in the same syringe/line. Do not use if the solution is turbid. For IV infusion, dilution in normal saline, lactated Ringer's, or D5W is recommended.
飼主須知
您的寵物正在接受去鐵胺治療，因為牠們攝入了達到毒性劑量的鐵（例如人類的鐵劑補充品或食品包裝中的脫氧劑）。
- 住院觀察：此藥物必須透過注射給藥，通常需要連續靜脈點滴，因此您的寵物需要留在醫院接受監測。
- 尿液顏色改變：您或獸醫人員可能會注意到寵物的尿液變成粉紅色或微紅色（常被形容為「玫瑰紅」）。這是正常且預期中的現象，代表藥物正在成功結合鐵質並透過腎臟將其排出。治療通常會持續到尿液顏色恢復正常為止。
- 後續追蹤：即使治療成功，鐵中毒仍可能對胃腸道造成損傷。在接下來的 4 到 6 週內，請在家密切觀察寵物是否有嘔吐、排出黑色柏油狀糞便或腹痛的跡象，因為有時可能會發展出腸胃道狹窄（疤痕組織阻塞）。
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