When to start Chelation?
Serum ferritin levels should be assessed after 12-15 transfusions. Chelation therapy should be initiated when serum ferritin is above 1000ng/ml. 1. DESFERAL (Desferioxamine) Dose 25-50 mg/kg/day subcutaneous with the help of infusion pump over 8-12 hours. Ten percent Desferal solution is prepared in water for injection i.e. one vial of Desferal is dissolved in 5ml water for injection. If more than one vial is to be administered 2.5 to 5 ml of water for injection can be added per vial of Desferal. Desferal solution should not be stored for more than 24 hours. Subcutaneous Desferal can be given in the abdomen at 1″ away from umbilicus, antero-medial thighs and in adolescents/adults also at triceps. It should be given subcutaneous over 8-12 hours. Infusion pumps and special 27G short needle, long tubing scalp vein sets are available with Thalassemia Societies at subsidized cost. Desferal should never be added in blood bag. However, it can be given along with blood transfusion with the hel
