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The safety and warning information for Deferoxamine (Desferal) highlights critical considerations for safe usage. Please review these points carefully and discuss any concerns with your healthcare provider.

• Vision and Hearing Problems: Use of Deferoxamine (Desferal) may lead to vision issues such as blurred vision, cataracts, blind spots, or vision loss, as well as hearing complications like ringing in the ears or hearing loss. These effects are more prevalent at high doses and with prolonged use. Regular vision and hearing tests are recommended during extended treatment periods. These side effects often resolve after discontinuing the medication. High doses and low levels of iron-storing proteins elevate the risk.

• Kidney Issues: This medication can cause kidney damage, potentially resulting in kidney failure. Regular kidney function tests may be necessary during treatment. Deferoxamine should not be used in individuals with severe kidney damage, as the kidneys are crucial for excreting the medication. Symptoms of kidney damage include swelling in extremities, reduced urine production, fatigue, confusion, and breathing difficulties.

• Growth Concerns in Children: In children, especially those starting treatment before age 4, high doses of Deferoxamine (Desferal) can slow growth or cause bone changes, which may lead to fractures. Monitoring of height and weight every three months is advised. Growth patterns may partially normalize after stopping treatment. Risks increase with high doses and low iron-storing protein levels.

• Respiratory Issues: The medication can cause lung fluid accumulation, leading to breathing difficulties, reduced blood flow, and potential lung damage. This condition is serious and requires immediate medical attention. It is more likely with high IV doses, short-term iron overload, and certain blood disorders. Consult your provider if breathing problems arise post-treatment.

• Infusion Reactions: Rapid IV infusion of Deferoxamine (Desferal) can provoke severe reactions such as flushing, hives, low blood pressure, and shock. To mitigate these risks, it should be administered via muscle injection, subcutaneous infusion, or slow IV infusion. The risk is heightened with rapid IV infusions.

• Infections: There is an increased risk of bacterial or fungal infections while on this medication. If symptoms like cough, fever, congestion, diarrhea, or stomach pain occur, contact your provider and cease medication to address the infection promptly.

Contraindications: This medication should not be used by individuals with severe kidney problems or those unable to produce urine due to the significant health risks. Always consult with your healthcare provider if these conditions apply to you.

Common side effects:

• irritation at the injection site
• pain at the injection site
• itching at the injection site
• swelling at the injection site
• headaches
• nausea
• joint and muscle pain
• fever
• vomiting
• stomach pain

Less common but important to monitor:

• diarrhea
• asthma or trouble breathing
• rash
• muscle spasms
• hearing or vision problems
• slowed growth
• bone changes

Serious side effects:

• severe fungal infections
• serious allergic reactions
• infusion reactions
• serious lung problems
• serious kidney issues

Interactions with high risk of serious adverse effects and should be avoided:

• Vitamin C (ascorbic acid) when there is a heart failure condition

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Prochlorperazine
• Ascorbic Acid
• Busulfan