Administration

INFUSION

• For a final IV concentration of 4 mg/mL: Add 2 g (1 x 2 g vial or 4 x 500mg vials; 9.5 ml of 210 mg/ml solution [approximate values]) to 500 mL of sodium chloride 0.9% or dextrose 5% in water. 
• Maximum rate of administration is 15 mg/kg/hour. (Note the possible adverse effects of rapid and prolonged administration mentioned in potential hazards of administration section).

Compatibility, Stability

• Compatible with sodium chloride 0.9%, dextrose 5% in water and lactated ringer’s.
• Stable for 24 hours at room temperature.

Potential Hazards of Administration

• Infusions greater than 24 hours may be associated with severe or fatal pulmonary toxicity.
• Headache, nausea, urticaria, arthralgia, myalgia, fever.
• Pain and induration at the site of injection.
• Reddish discolouration of the urine as chelated iron is being excreted.
• Allergic reactions (dermatological, anaphylaxis).
• Respiratory distress syndrome has been reported following IV administration of excessive doses. Treatment should be interrupted if signs of toxicity occur.
• Rapid IV injection (greater than 15 mg/kg/hour) has produced flushing, urticaria, hypotension and shock.
• Decreased serum glucose, sodium, calcium and increase blood coagulability.
• Infection with yersinia species or mucormycosis may be promoted by deferoxamine.
• Visual disturbances, hearing loss and audiometric abnormalities have been reported, especially if high doses used. Serial ophthalmological and audiological testing should be performed, if symptoms noted and then as necessary.

Miscellaneous

• Use with caution in patients with impaired renal function. Adequate urine output is required to excrete the deferoxamine-iron complex. If oliguria or anuria develop, dialysis may be required.