- Systemic iron toxicity: Severe gastroenteritis, shock, metabolic acidosis and altered GCS
- Iron levels >90 micro mol/L or 500 microgram/dL at 4-6 hours post ingestion
- Chronic iron overload
- Cardiac monitoring is required.
- Reconstitute 500mg of powder with 5ml of sterile water and dilute in 100ml of 0.9% saline or 5% dextrose.
- Commence IV infusion at an initial dose of 15 mg/kg/hour. Can be reduced if hypotension develops.
- The rate may be increased in life-threatening toxicity up to 40 mg/kg/hour if blood pressure allows.
- Continue the infusion until the patient is clinically stable and the serum iron <60 micro mol/L (350 microgram/dL), but avoid infusion >24 hours (6 hours is usually sufficient).
- Paediatric Dose = same as for adults
- ARDS (for infusions >24 hours)
- Toxic Retinopathy
- Infection (Yersinia and mucormycosis grow avidly with the ferrioxamine complex)
- Rose urine – classical sign but does not necessarily indicate effective chelation.
- Howland MA. Risks of parenteral deferoxamine for acute iron poisoning. Journal of Toxicology – Clinical Toxicology 1996; 34(5):491-497.
- Tenenbein M. Benefits of parenteral deferoxamine for acute iron poisoning. Journal of Toxicology – Clinical Toxicology 1996; 42(5):485-489.