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Deferoxamine (Desferal) Subcutaneous Infusions

These instructions are for Children's Hospital of Philadelphia (CHOP) patients prescribed deferoxamine (Desferal) subcutaneous infusions to remove excess iron from their body.

Important information:

Deferoxamine, also known by the brand name Desferal®, is a medicine used to treat iron overload that happens after multiple blood transfusions. The medicine works by attaching to iron in the body and helping it to leave the body in urine and stool. Having too much iron in your body can lead to long-term heart, liver and endocrine problems.

Deferoxamine is given as an infusion under the skin into the fatty tissue (subcutaneously) by a pump. It is given over 8-24 hours.

Deferoxamine will be delivered to your home weekly. The pharmacy must make contact with you before delivery. The medicine arrives premixed and ready to use with your home pump. Your home care company will bring the pump to your home and teach you how to use it.

Side effects are most likely to happen with the first dose of deferoxamine. That's why your child will have their first infusion in the Alex Scott Day Hospital, where your team can watch them closely. When giving the medicine at home, stop the infusion if your child is:

  • Dizzy

  • Weak

  • Feels flushed

  • Develops hives or becomes itchy

Your child's urine may be pink or salmon colored. This is a normal and expected side effect.

Patient instructions for deferoxamine subcutaneous infusions:

Store the medicine as you were taught. Give as directed by your healthcare team.

Choose a site for the infusion. The best places for the subcutaneous needle are in the fatty sections of the stomach. Some people use the fatty part of the thighs. You should be able to pinch skin at the site to bring the fatty tissue away from the muscle.

Injection Sites

Catheter set

  1. Gather your supplies.

  2. Wash hands.

  3. Select a site. Choose a new site each time. This helps to prevent skin irritation.

  4. Numb the site with ice if desired.

  5. Clean the site for 15 seconds with alcohol and allow it to completely dry before placing the needle.

  6. Connect the medicine syringe to the extension tubing and attach the extension tubing to the needle set.

  7. Use the pump to prime the tubing with the medicine to just before the end of the needle set.

  8. Remove paper tabs from the wings of the needle set (Figure 1).

  9. Remove protective cover of the needle (Figure 1).
    Remove protective cover of the needle

  10. Hold the wings of needle set with your thumb and middle finger. Place your index/pointer finger on the back of the needle.

  11. Use your other hand to grasp the skin around the site to pinch skin and bring fatty tissue up. (Figure 2)
    Use your other hand to grasp the skin around the site to pinch skin and bring fatty tissue up.

  12. Insert needle directly into the skin and tissue. (Figure 3)
    Insert needle directly into the skin and tissue.

  13. Gently push the wings to secure the adhesive.

  14. Apply two dressings to cover the needle set:

    • Remove the backing of the rectangle dressing.

    • Place the opening in the dressing over the needle and smooth it down.

    • Remove the backing of the smaller dressing. Place it over the first dressing and needle.
      Gently push the wings to secure the adhesive.

  15. While holding onto the wings under the dressing to secure the catheter, use your other hand to pull on the blue top of the needle and remove the needle.

  16. Throw away needle as directed by your home care company.

  17. Set pump as directed by your home care company.

When the infusion is complete:

  1. Wash your hands.

  2. Remove dressings and remove catheter tubing from the site.

  3. Apply gentle pressure at the site if needed for bleeding.

  4. Throw away tubing as directed by home care company.

  5. Wash your hands again when you are finished.

Contact your CHOP healthcare team with questions, concerns or if you have trouble with the pump or infusion.

Call 911 if your child has signs of an allergic reaction such as swelling of the face, lips, tongue or throat; trouble breathing, wheezing or chest tightness. If you are concerned the reaction is related to deferoxamine, call your healthcare team after symptoms resolve to discuss a plan moving forward.

Division of Hematology | Thalassemia Center

215-590-3535

CHOP Main patients:
8:30am-5:00pm, Monday-Friday
215-590-3437

Voorhees patients
8:00am-4:30pm, Monday-Friday
856-435-7502

King of Prussia patients:
8:00am-4:30pm, Monday-Friday
267-425-3320

Weekends, holidays and every day after
5:00pm, all patients: 215-590-1000, ask the
hospital operator for the hematologist on call.

For non-urgent issues, send your team a message in the MyCHOP portal.

 

Reviewed on June 6, 2023, by Janet Kwiatkowski, MD, MSCE; Rebecca Kendsersky, PharmD, BCPPS

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