Patients with asymptomatic ingestion of <20mg/kg only require observation x 6hr
Volume resuscitation
Initiate for large overdoses of<unk> 
Do not base only on radioopaque evidence of<unk>  pills as not all formulations are readily visible on XR
Orogastric lavage only is not likely to be successful after<unk>  tablets have moved past the pylorus
Supported by case reports and uncontrolled case series, but rationale behind it makes it largely supported by toxicologists
Promotes increased gastric emptying and avoids large bezoar formation
Indications
Pregnancy
Systemic toxicity and<unk>  level > 350 mcg/dL<unk>  level >500mcg/dL
Metabolic acidosis
Altered Mental Status
Progressive symptoms, including shock, coma, seizures, refractory GI symptoms
Large number of pills on KUB
Estimated dose > 60mg/kg Fe2+
Administered IV due to poor oral absorption
One mole of Deferoxamine (100mg) binds one mole of<unk>  (9mg) to form ferrioxamine
Results in vin-rose urine (ferrioxamine is a reddish compound)
May increase to 15 mg/kg/hr (determined empirically and never clinically tested), max 35 mg/kg/hr or 6 g total per day
Can start slower at 5-8 mg/kg/hr if concern for hypotension and uptitrate
Can give 90 mg/kg IM if unable to obtain IV
However IVF resuscitation is critical so IV access should be established ASAP
Adverse reactions
Hypotension
May cause flushing (anaphylactoid reaction)
Rarely causes ARDS - associated with prolonged use
Probably safe to use in pregnancy (give if obvious signs of shock/toxicity)
Pregnancy
Systemic toxicity and<unk>  level > 350 mcg/dL<unk>  level >500mcg/dL
Metabolic acidosis
Altered Mental Status
Progressive symptoms, including shock, coma, seizures, refractory GI symptoms
Large number of pills on KUB
Estimated dose > 60mg/kg Fe2+
One mole of Deferoxamine (100mg) binds one mole of<unk>  (9mg) to form ferrioxamine
Results in vin-rose urine (ferrioxamine is a reddish compound)
Can start slower at 5-8 mg/kg/hr if concern for hypotension and uptitrate
Can give 90 mg/kg IM if unable to obtain IV
However IVF resuscitation is critical so IV access should be established ASAP
Hypotension
May cause flushing (anaphylactoid reaction)
Rarely causes ARDS - associated with prolonged use
Probably safe to use in pregnancy (give if obvious signs of shock/toxicity)
Not effective in removing<unk>  due to large volumes of distribution
Dialysis can removes deferoxamine-iron complex in renal failure patients
Minimal evidence but has been described in larger overdoses
Does not remove large numbers of pills and may have serious adverse events
Does not bind<unk> 
1-800-222-1222 (United States)
Iron toxicity
Aluminum toxicity
Zinc toxicity
Antimony toxicity
Gold toxicity
Arsenic toxicity
Nickel toxicity
Barium toxicity