Desferal Caution For Usage

Instructions for Use and Handling: When administered parenterally, the drug should be used as a 95 mg/mL solution in water for injection except for i.m. injection where a higher concentration may be necessary. Preparation of powder for solution for injection is given in Tables 2 and 3 for subcutaneous, intraveneous and intramuscular administrations, respectively. After the appropriate amount of water for injection is injected into the vial containing Desferal powder, the vial is shaken well. Only clear and colorless to slightly yellowish solutions should be used (see also Precautions). (See Tables 2 and 3.)

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The 95 mg/mL Desferal solution after reconstitution can be further diluted with routinely employed infusion solutions (NaCl 0.9%, glucose 5%, Ringer's solution, Ringer-Lactate solution, peritoneal dialysis solutions such as Dianeal 137 Glucose 2.27%, Dianeal PD4 Glucose 2.27%, and CAPD/DPCA 2 Glucose 1.5%).
For the Desferal infusion test and the treatment of chronic aluminum overload, the 5.3 mL Desferal solution in the 500 mg vial is an adequate dose (5 mg/kg) for a patient with 100 kg body weight. According to the actual body weight of the patient, the appropriate amount of Desferal solution is withdrawn from the vial and added to 150 mL 0.9% saline (NaCl solution).
Dissolved Desferal can also be added to the dialysis fluid and given intraperitoneally to patients on CAPD or CCPD.
The use of Desferal in chronic iron overload by means of a portable infusion pump is described in the patient information as follows: 1. Draw the water for injection into a syringe.
2. After cleaning the rubber stopper of the Desferal vial with alcohol, inject the contents of the syringe into the vial.
3. Shake the vial thoroughly to dissolve the powder.
4. Draw the solution so obtained into the syringe.
5. Attach the extension tube to the syringe, connect the extension tube to the butterfly-type needle, and then fill the empty space in the tube with the solution in the syringe.
6. Place the syringe in the infusion pump.
7. For infusion you may insert the butterfly-type needle under the skin of the abdomen, arm, upper leg or thigh. It is important to first clean the skin very thoroughly with alcohol. Then insert the needle firmly, up to the wings, into a fold of the skin formed by your free hand. The tip of the needle should move freely when the needle is waggled. If it doesn't move freely, the tip of the needle may be too close to the skin. Try again at a new site after cleaning it with alcohol.
8. Then fix the needle and tape it down.
9. Patients usually wear the pump on the body using a belt or shoulder holster. Many patients consider overnight use to be most convenient.
Incompatibilities: Heparin injectable solution; Physiological saline (0.9%) should not be used as a solvent for the dry substance, but, after reconstitution of the Desferal solution with water for injection, it can be employed for further dilution.