Deferoxamine

Pronunciation: de-fer-OX-a-meen.

Generic name
deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US)
Drug class
Iron and aluminum chelating agent
Form
Lyophilized powder for injection (500 mg or 2 g per vial), reconstituted before use
Route
Subcutaneous, intravenous, or intramuscular injection/infusion
Legal status
Prescription-only, administered by or under the supervision of a clinician

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Desferal (original Novartis brand) (5), DBL Desferrioxamine Mesylate for Injection BP (5) · Full directory

What deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US) is and how it works

Deferoxamine is an injectable medicine that binds to (chelates) excess iron and aluminum in the body so it can be removed through urine and stool. It is used as an add-on treatment for acute iron poisoning and, more commonly, to manage chronic iron overload in people who receive frequent blood transfusions (such as for thalassemia or other chronic anemias), as well as for aluminum overload in people on dialysis. (1) (2)

Deferoxamine has no FDA boxed warning, but it carries several genuine, serious, dose-dependent risks: effects on vision and hearing (usually reversible if caught early and treatment is stopped), slowed growth in children given doses too high for their iron levels, lung injury at very high intravenous doses, and rare but serious infections. Because of these risks, your care team will monitor your eyes, hearing, growth (in children), and general health regularly while you are on this medicine, and will adjust your dose based on blood iron/ferritin levels.

Mechanism of action: how deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US) works

Deferoxamine is a chelating agent that binds free iron (and, to a lesser extent, aluminum) to form a stable, water-soluble complex (ferrioxamine), which is then excreted mainly in urine and to a lesser extent in bile/stool. Approximately 100 mg of deferoxamine binds about 8.5 mg of ferric iron and about 4.1 mg of aluminum. (2) (1)

What deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US) is used for

Chronic iron overload from repeated blood transfusions

Used to remove excess iron that builds up from regular blood transfusions in conditions such as thalassemia, sideroblastic anemia, and other chronic anemias. (1) (6)

Acute iron poisoning

Used as an add-on to standard emergency measures for acute iron overdose/poisoning. (1) (2)

Aluminum overload in dialysis patients

Used to remove excess aluminum in people receiving long-term dialysis. (2)

Diagnostic aid for iron storage disease

Sometimes used to help confirm a diagnosis of an iron storage disorder. (2)

Before taking deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US)

Do not take / not appropriate for

  • Do not use deferoxamine if you have a known hypersensitivity to it, unless your specialist can safely desensitise you first. (United Kingdom) (2)
  • Do not use deferoxamine if you have severe kidney disease or anuria (absence of urine production), per US labeling. (United States) (1)

Tell your clinician about

  • Any problems with your vision or hearing, now or in the past, since these need to be checked before starting and every 3 months during treatment.
  • If your child is under 3 years old, since dosing must be kept below a specific limit to avoid growth problems.
  • Any history of lung disease, since very high intravenous doses have been linked to serious lung injury.
  • Whether you take prochlorperazine (an anti-nausea/anti-psychotic medicine), since combining it with deferoxamine has caused prolonged loss of consciousness in rare cases.
  • Any fever, sore throat, or abdominal pain during treatment, since these can be early signs of a rare but serious infection linked to deferoxamine.
  • Your current ferritin (iron level) results, since your dose is based on these, not on a fixed schedule.
(1) (2) (6)

How to take deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US)

  • Deferoxamine is given by injection or infusion (under the skin, into a vein, or into a muscle) -- it is prepared and administered by, or under the direct guidance of, a clinician or trained caregiver, never a medicine you start or adjust on your own.
  • Your dose is based on your iron level (ferritin) and how it changes over time, not a fixed amount -- do not change your dose or schedule without your care team's specific instruction.
  • Attend all scheduled eye, hearing, and (for children) growth check-ups -- these are how your care team catches early signs of a dose that may be too high for your current iron level.
(2) (1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

Contact your care team for guidance on a missed dose or infusion -- do not take an extra dose or change your schedule on your own, since dosing is individually calculated based on your iron levels.

Overdose

Seek urgent medical attention for a suspected overdose. Very high intravenous doses have specifically been linked to acute respiratory distress syndrome (ARDS), a serious lung injury -- this is why intravenous dosing limits are followed strictly and infusions are given under clinical supervision. (1) (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Local reactions at the injection/infusion site, such as pain, swelling, redness, or itching.

What to notice: Local reactions at the injection/infusion site, such as pain, swelling, redness, or itching.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Gastrointestinal symptoms such as nausea, vomiting, or diarrhoea.

What to notice: Gastrointestinal symptoms such as nausea, vomiting, or diarrhoea.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Headache and general discomfort.

What to notice: Headache and general discomfort.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of eye (ocular) toxicity — high caution

Symptoms: Blurred vision, reduced sharpness of vision, difficulty seeing at night or telling colors apart, blind spots, or other new visual changes.

Action: Contact your clinician promptly -- you will have eye examinations before starting treatment and every 3 months during it. These effects are usually reversible if treatment is stopped right away, but need prompt evaluation and are more likely with prolonged treatment, higher doses, or low iron (ferritin) levels. (1) (2)

Signs of hearing (auditory) toxicity — high caution

Symptoms: Ringing in the ears (tinnitus) or new difficulty hearing, especially high-pitched sounds.

Action: Contact your clinician promptly -- hearing tests (audiometry) are part of your regular monitoring. These effects are usually reversible if treatment is stopped right away, but need prompt evaluation. (1) (2)

Slowed growth in children — high caution

Symptoms: Slower-than-expected growth in height or weight gain over time (usually only detected through regular growth checks, not something a parent would necessarily notice day to day).

Action: Attend all scheduled growth check-ups (height and weight roughly every 3 months) -- your child's clinician will adjust the dose based on these results and iron levels. (1) (2)

Signs of serious lung injury (with very high intravenous doses) — high caution

Symptoms: Severe shortness of breath, rapid breathing, or breathing difficulty during or after a high-dose intravenous infusion.

Action: This is a medical emergency requiring immediate treatment by the clinical team administering the infusion. This is why intravenous dosing limits are followed strictly. (1) (2)

Signs of a serious infection (mucormycosis or Yersinia) — high caution

Symptoms: Fever combined with a sore throat, or fever with abdominal pain, during deferoxamine treatment.

Action: Contact your clinician promptly -- rare but serious, sometimes fatal, fungal (mucormycosis) or bacterial (Yersinia) infections have occurred in people on deferoxamine, and fever with these specific symptoms should prompt urgent medical review, with the clinician deciding on continuation pending investigation. (1) (2)

Signs of a serious allergic reaction — emergency

Symptoms: Flushing, hives, difficulty breathing, or a sudden drop in blood pressure (shock).

Action: Seek emergency medical help immediately. (1)

Prolonged loss of consciousness after taking prochlorperazine together with deferoxamine — high caution

Symptoms: Unresponsiveness or loss of consciousness lasting up to 48-72 hours after both medicines were given together.

Action: This is a recognised, specific interaction -- tell every prescriber that you are taking deferoxamine before starting prochlorperazine or any new anti-nausea/anti-psychotic medicine. (6)

Interactions

  • Prochlorperazine: co-administration with deferoxamine has been reported to cause transient metabolic encephalopathy with loss of consciousness lasting 48-72 hours -- a specific, real interaction, not a generic caution. (6)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Use in pregnancy is decided individually by the treating clinician, weighing the risk of untreated iron/aluminum overload against any potential risk of treatment. (1) (2) (3) (4) (5) (6)

Breastfeeding

Discuss breastfeeding with your clinician while on treatment. (1) (2) (3) (4) (5) (6)

Children

Used in children, including for chronic transfusional iron overload; children under 3 years old should not exceed 40 mg/kg/day due to a specific growth-retardation risk, and growth should be monitored roughly every 3 months. (1) (2) (3) (4) (5) (6)

Elderly

No specific dose adjustment identified beyond the general ferritin-based dosing approach used for all patients. (1) (2) (3) (4) (5) (6)

Hepatic_impairment

No specific dose adjustment identified in the sources reviewed. (1) (2) (3) (4) (5) (6)

Renal_impairment

Contraindicated in severe renal disease or anuria per US labeling; used with specific weekly dosing during dialysis for aluminum overload. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Baseline ophthalmological assessment (visual field, fundoscopy, colour vision testing, slit-lamp examination)
  • Baseline audiological assessment (audiometry)
  • Ferritin/iron studies
  • Kidney function
  • For children: baseline height and weight

During treatment

  • Ophthalmological and audiological assessment at 3-monthly intervals, particularly if ferritin levels are low.
  • 3-monthly height and weight monitoring in children.
  • Ongoing ferritin monitoring to guide dose adjustments.
  • Prompt evaluation of any fever with pharyngitis or abdominal pain.
(2) (1)

Storage

Store the unreconstituted powder as directed on the product label; use reconstituted solution according to your care team's or the product's specific stability instructions. Keep out of reach of children.

Professional information

Clinician-facing context only, sourced from the current US FDA, UK EMC, and Health Canada labels reviewed for this dossier; verify against the current full label before prescribing.

United States

Indication: Chronic iron overload

Dose summary: SC 20-60 mg/kg/day based on ferritin; IV pediatric 20-40 mg/kg/day (max 40 mg/kg/day), adult 40-50 mg/kg/day over 8-12 hours (max 60 mg/kg/day); IM up to 500-1,000 mg/day.

Renal context: Contraindicated in severe renal disease or anuria. (1)

United Kingdom

Indication: Acute iron poisoning

Dose summary: IV 15 mg/kg/hour, maximum 80 mg/kg in 24 hours.

Renal context: Not separately addressed for this indication in the source reviewed. (2)

Mechanism of action

Hepatic guidance

No specific hepatic dose adjustment identified in the sources reviewed.

Overdose note

Management of overdose or excessively high intravenous dosing is supportive, with particular attention to respiratory status given the recognised ARDS risk at very high IV doses. (2) (1)

Frequently asked questions

Why do I need regular eye and hearing tests while on deferoxamine?

Deferoxamine carries a genuine, dose-dependent risk of eye problems (including blurred vision, reduced visual acuity, and, rarely, cataracts or retinal changes) and hearing problems (including ringing in the ears and hearing loss). These risks rise with prolonged treatment, higher doses, or low iron (ferritin) levels, and are usually reversible if caught early and treatment is adjusted or stopped -- which is exactly why eye and hearing tests are recommended before starting and every 3 months during treatment. (1) (2)

Is it safe to give deferoxamine to a young child?

Deferoxamine is used in children for chronic iron overload, but children under 3 years old need their daily dose kept at or below 40 mg/kg to reduce a specific, recognised risk of growth suppression, and growth (height and weight) is checked roughly every 3 months. Always follow your child's specialist's specific dosing instructions rather than a general figure. (2)

Can I take an anti-nausea medicine while on deferoxamine?

Be cautious with prochlorperazine specifically -- combining it with deferoxamine has been linked to a rare but serious reaction causing loss of consciousness for up to 48-72 hours. Always tell any prescriber that you are on deferoxamine before starting a new anti-nausea or anti-psychotic medicine. (6)

Is Desferal still available, since I heard the brand changed hands?

Yes -- deferoxamine remains available. The Desferal brand's worldwide rights were acquired by MITEM PHARMA from Novartis in 2024, which is a change of manufacturer/owner, not a withdrawal. Separately, in Australia specifically, the original Novartis 'Desferal' brand registration was cancelled in 2019, but the same active medicine remains available there under a different brand (DBL Desferrioxamine Mesylate). Ask your pharmacist which brand is stocked in your country. (3) (5)

What is the mechanism of action of deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US)?

Deferoxamine is a chelating agent that binds free iron (and, to a lesser extent, aluminum) to form a stable, water-soluble complex (ferrioxamine), which is then excreted mainly in urine and to a lesser extent in bile/stool. Approximately 100 mg of deferoxamine binds about 8.5 mg of ferric iron and about 4.1 mg of aluminum. (2) (1)

What is the generic name of Deferoxamine?

The generic name is deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US). (1) (3)

What class of drug is deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US)?

Deferoxamine is classed as: Iron and aluminum chelating agent. (1) (3)

References

  1. DESFERAL (deferoxamine mesylate) for injection -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Novartis Pharmaceuticals Corporation · United States · accessed 2026-07-31 · source 1
  2. Desferal Vials, 500mg -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-31 · source 2
  3. Deferoxamine (Desferal) as the established pre-existing EU iron-chelation treatment; MITEM PHARMA acquisition of worldwide DESFERAL rights from Novartis (2024)European regulatory/commercial context (EMA public materials referencing deferoxamine as pre-existing standard of care; MITEM PHARMA acquisition announcement) · European Union · accessed 2026-07-31 · source 3
  4. DESFERAL (deferoxamine mesylate for injection) -- Product MonographHealth Canada product monograph, Novartis Pharmaceuticals Canada Inc. · Canada · accessed 2026-07-31 · source 4
  5. DESFERAL desferrioxamine mesilate 2g -- ARTG 72343 (CANCELLED, sponsor Novartis Pharmaceuticals Australia Pty Ltd, effective 13 February 2019); DBL DESFERRIOXAMINE MESYLATE FOR INJECTION BP 500mg -- ARTG 53942 (ACTIVE, sponsor Pfizer Australia Pty Ltd, registered 11 January 1996)Therapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-31 · source 5
  6. DBL Desferrioxamine Mesylate for Injection BP -- New Zealand Data SheetMedsafe (New Zealand Medicines and Medical Devices Safety Authority) · New Zealand · accessed 2026-07-31 · source 6

Brand names by country

Single-ingredient deferoxamine mesylate (also spelled desferrioxamine mesylate outside the US) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Desferal500 mg/5mL, 500 mg · mitem pharma

United Kingdom

  • Desferal (2)MHRA licensed emc smpc confirmed · 500 mg/vial · not fully specified in source (Novartis-associated per international sourcing)

Canada

  • DESFERAL

Australia

  • Desferal (original Novartis brand) (5)ARTG registration 72343 CANCELLED effective 2019-02-13 · 2 g · Novartis Pharmaceuticals Australia Pty Ltd
  • DBL Desferrioxamine Mesylate for Injection BP (5)ARTG 53942 registered 1996-01-11 licence status Active · 500 mg · Pfizer Australia Pty Ltd

New Zealand

  • DBL Desferrioxamine Mesylate for Injection BP (6)Medsafe data sheet confirmed updated 2023-10 · 500 mg, 2 g · not fully specified in source
View brands in additional countries.

European Union

Desferal (and other desferrioxamine brands, per member state) (3)

This page provides general reference information about deferoxamine (Desferal) and is not a substitute for advice from the clinician managing your treatment. All dosing, monitoring, and treatment-continuation decisions should be made with your prescriber or care team -- never stop, start, or change this medicine on your own.

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