Hypotension or an anaphylactoid-type reaction may occur from very rapid intravenous administration; this can be avoided by limiting the rate of administration to 15 mg/kg/h.
Local pain, induration, and sterile abscess formation may occur at intramuscular injection sites. Large intramuscular injections may also cause hypotension.
The ferrioxamine complex may itself cause hypotension and may accumulate in patients with renal impairment; hemodialysis may be necessary to remove the ferrioxamine complex.
Deferoxamine, as a siderophore, promotes the growth of certain bacteria, such as Yersinia enterocolitica, and may predispose patients to Yersinia sepsis.
Infusions exceeding 24 hours have been associated with pulmonary complications (acute respiratory distress syndrome).
Use in pregnancy. FDA Category C (indeterminate). Although deferoxamine is a teratogen in animals, it has relatively poor placental transfer, and there is no evidence that short-term treatment is harmful in human pregnancy (See Introduction in Section III). More importantly, failure to treat serious acute iron intoxications may result in maternal and fetal morbidity or death.