Deferoxamine Mesylate and Voltaren

• Generic Name: deferoxamine
• Dosage Forms: n.a.
• Other Brand Names: Desferal

Adjunctive therapy for acute iron intoxication.

Not a substitute for standard measures generally used, including GI decontamination (e.g., induction of emesis, gastric lavage, whole-bowel irrigation), suction and maintenance of airway, correction of acidosis, and control of shock with IV fluids, blood, oxygen, and vasopressors.

Recommended for patients with severe manifestations of iron intoxication (e.g., metabolic acidosis, repetitive vomiting, lethargy, coma, seizures, hypotension, GI bleeding, signs of shock) or serum iron concentration >500 mcg/dL; less serious ingestions may be treated with supportive care alone.

Treatment of chronic iron overload resulting from multiple transfusions in patients with thalassemia or other chronic anemias.

Long-term therapy may have beneficial effects on the liver (i.e., slow accumulation of hepatic iron, retard or eliminate progression of hepatic fibrosis).

In patients with thalassemia, long-term therapymay have beneficial effects on the heart (e.g., delay and/or prevent development of iron-associated cardiac disease, improve left ventricular function in patients with subclinical cardiac dysfunction, improve cardiac function in at least some patients with symptomatic cardiac disease ) and improve survival.

Initiate therapy early in the course of thalassemia (i.e., some clinicians recommend initiation of chelation therapy when serum ferritin concentrations reach 1000 ng/mL or child reaches the age of 3 years [see Pediatric Use under Cautions]) and monitor compliance closely; noncompliance with chelation regimen and failure to initiate therapy prior to development of irreversible tissue damage are associated with cardiac disease.

Diagnosis or treatment of aluminum-associated neurotoxicity and/or bone abnormalities in patients with chronic renal failure undergoing dialysis.

Has been used with some success for treatment of iron overload secondary to primary hemochromatosis. Phlebotomy is the method of choice for removal of excess iron; however, deferoxamine may be beneficial when phlebotomy is contraindicated.

Has been studied as a chelating agent for aluminum and its potential beneficial effects in patients with Alzheimer’s disease; not currently recommended for this use since existing evidence to support such use is weak and long-term chelation therapy may be associated with potentially serious adverse effects.

• Generic Name: diclofenac
• Dosage Forms: tablet, delayed release
• Other Brand Names: Voltaren, Voltaren-XR, also Cambia, Cataflam, Zipsor, Zorvolex, Dyloject, Cambia

Voltaren (diclofenac) is a nonsteroidal anti-inflammatory drug (NSAID). Voltaren works by reducing substances in the body that cause pain and inflammation.

Voltaren oral tablets are used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis. Voltaren is also used to treat ankylosing spondylitis.

Voltaren ophthalmic eyedrops are used to treat pain, inflammation, and light sensitivity after eye surgery or for certain eye conditions.

Voltaren gel is used to treat osteoarthritis of the knees and hands.

You should not use Voltaren if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs).

Voltaren can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Voltaren may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Voltaren, especially in older adults.