AHFS Class:

64:00 Heavy Metal Antagonists

Generic Name

• Deferoxamine Mesylate

Deferoxamine mesylate is available as a lyophilized powder in vials containing 500 mg or 2 g of deferoxamine mesylate.⁴⁰⁰²; ⁴⁰⁰³ For intramuscular injection, reconstitute the 500-mg or 2-g vials with 2 or 8 mL, respectively, of sterile water for injection to yield solutions containing deferoxamine mesylate 213 mg/mL.⁴⁰⁰²; ⁴⁰⁰³ For intravenous and subcutaneous infusion, reconstitute the 500-mg or 2-g vials with 5 or 20 mL, respectively, of sterile water for injection to yield solutions containing deferoxamine mesylate 95 mg/mL.⁴⁰⁰²; ⁴⁰⁰³ For intravenous infusion, the reconstituted solution must be further diluted in 150 mL of a compatible infusion solution to a deferoxamine mesylate concentration between 3 and 3.5 mg/mL.⁴⁰⁰²; ⁴⁰⁰³

Equivalency

Deferoxamine mesylate 500 mg is equivalent to 426.82 mg of deferoxamine base,⁴⁰⁰²; ⁴⁰⁰³ Deferoxamine mesylate 2 g is equivalent to 1707.28 mg of deferoxamine base,⁴⁰⁰³

Tonicity

Reconstituted solutions are isotonic.⁴⁰⁰²; ⁴⁰⁰³

Trade Name(s)

Desferal

Deferoxamine mesylate is administered by intramuscular injection, subcutaneous infusion, or by intravenous infusion after dilution.⁴⁰⁰²; ⁴⁰⁰³ Subcutaneous infusion may be given using a portable infusion pump over 8 to 12 hours or 24 hours.⁴⁰⁰²; ⁴⁰⁰³ Intravenous infusion may be given over 8 to 12 hours at a rate not exceeding 15 mg/kg/hr or, for certain indications, at an initial rate not exceeding 15 mg/kg/hr for the first 1000 mg with subsequent doses at a decreased rate not exceeding 125 mg/hr.⁴⁰⁰²; ⁴⁰⁰³

Intact vials should be stored at controlled room temperature.⁴⁰⁰²; ⁴⁰⁰³ Deferoxamine mesylate is a white to almost white powder that forms a clear, colorless to slightly yellowish solution upon reconstitution.⁴⁰⁰²; ⁴⁰⁰³ Reconstituted solutions may be stored at controlled room temperature for up to 24 hours and should not be refrigerated.⁴⁰⁰²; ⁴⁰⁰³

Syringes

Deferoxamine mesylate (Ciba-Geigy) 250 mg/mL in sterile water for injection 3 mL in 10-mL polypropylene infusion pump syringes (Pharmacia Deltec) had little loss in 14 days of storage at 30°C.¹⁹⁶⁷

Ambulatory Pumps

Deferoxamine mesylate stability was evaluated at concentrations of 210, 285, and 370 mg/mL in sterile water for injection in PVC infusion cassette reservoirs (Pharmacia Deltec) stored at 20 to 23°C. Analysis was inconclusive because of an inordinate degree of assay variation. However, a white precipitate formed in varying time periods, depending on the concentration. Higher concentrations precipitated more rapidly than lower concentrations. In the 370-mg/mL concentration, precipitation was observed in as little as 1 day while the 285- and 210-mg/mL concentrations developed precipitation in 9 and 17 days, respectively. This study’s inordinate degree of assay variability coupled with the propensity for precipitation preclude a reasonable determination of stability for these high concentrations of deferoxamine mesylate.⁶⁷²

Elastomeric Reservoir Pumps

Deferoxamine mesylate (Ciba-Geigy) 5 mg/mL in both dextrose 5% and sodium chloride 0.9% was evaluated for binding potential to natural rubber elastomeric reservoirs (Baxter). No binding was found after storage for 2 weeks at 35°C with gentle agitation.²⁰¹⁴

Solution Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions September 12, 2024. © Copyright, 2025. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.