DRUG INTERACTIONS
Drug Interactions
Vitamin C:
Patients with iron overload usually become vitamin C deficient, probably because iron oxidizes the vitamin. As an adjuvant to iron chelation therapy, vitamin C in doses up to 200 mg for adults may be given in divided doses, starting after an initial month of regular treatment with deferoxamine mesylate (see
PRECAUTIONS
). Vitamin C increases availability of iron for chelation. In general, 50 mg daily suffices for children under 10 years old and 100 mg daily for older children. Larger doses of vitamin C fail to produce any additional increase in excretion of iron complex.
Prochlorperazine:
Concurrent treatment with deferoxamine mesylate and prochlorperazine, a phenothiazine derivative, may lead to temporary impairment of consciousness.
Gallium-67:
Imaging results may be distorted because of the rapid urinary excretion of deferoxamine mesylate-bound gallium-67. Discontinuation of deferoxamine mesylate 48 hours prior to scintigraphy is advisable.
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OVERDOSAGE
Acute Toxicity
Intravenous LD50s (mg/kg): mice, 287; rats, 329.
Signs and Symptoms
Inadvertent administration of an overdose or inadvertent intravenous bolus administration/rapid intravenous infusion may be associated with hypotension, tachycardia and gastrointestinal disturbances; acute but transient loss of vision, aphasia, agitation, headache, nausea, pallor, CNS depression including coma, bradycardia and acute renal failure have been reported.
Treatment
There is no specific antidote. Deferoxamine mesylate should be discontinued and appropriate symptomatic measures undertaken.
Deferoxamine mesylate is readily dialyzable.
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