Some science behind the scenes

Deferoxamine

Deferoxamine (also known as desferrioxamine B, desferoxamine B, DFO-B, DFOA, DFB or desferal) is a bacterial siderophore produced by the Actinobacteria Streptomyces pilosus. It has medical applications as a chelating agent used to remove excess iron from the body. That is it is used in iron overdose and poisoning.  The mesylate salt of DFO-B is commercially available.

Apart from iron toxicity, deferoxamine has been used to treat aluminium toxicity (an excess of aluminium in the body). In the US, the drug is not FDA-approved for this use.

Deferoxamine is also used to treat hemochromatosis, a disease of iron accumulation that can be either genetic or acquired. Acquired hemochromatosis is common in patients with certain types of chronic anemia (e.g. thalassemia and myelodysplastic syndrome) who require many blood transfusions, which can greatly increase the amount of iron in the body. Administration for chronic conditions is generally accomplished by subcutaneous injection over a period of 8–12 hours each day. Administration of deferoxamine after acute intoxication may color the urine a pinkish red, a phenomenon termed "vin rosé urine".

Deferoxamine acts by binding free iron in the bloodstream and enhancing its elimination in the urine. By removing excess iron, the agent reduces the damage done to various organs and tissues, such as the liver. 

It is not without its problems, if we use the eHealthme side effects chart the most common Deferoxamine Mesylate side effects are:

  • Drug Exposure During Pregnancy  (22 reports)
  • Serum Ferritin Increased  (18 reports)
  • Fundoscopy Abnormal  (17 reports)
  • Visual Acuity Reduced  (12 reports)
  • Anaemia  (12 reports)
  • Fever  (11 reports)
  • Haemoglobin Decreased  (11 reports)
  • Iron Overload  (11 reports)
  • Mucormycosis  (9 reports)
  • White Blood Cell Count Increased  (9 reports)

By looking at the case histories it would appear that the side effects were largely due to misuse.  There was even one patient who was taking this for 6 months!