PREVENTION OF GASTROINTESTINAL IRON-ABSORPTION BY CHELATION FROM AN ORALLY-ADMINISTERED PREMIXED DEFEROXAMINE CHARCOAL SLURRY/

Study objective: To investigate the effect of an orally administered p remixed slurry of deferoxamine mesylate (DFO) and activated charcoal ( AC) on the gastrointestinal (GI) absorption of ferrous sulfate under p hysiologic conditions. Methods: This was a prospective, crossover, con trolled human volunteer study. Participants were healthy adult subject s aged 25 to 38 years. Volunteers ingested either 5 mg/kg ferrous sulf ate alone, 5 mg/kg ferrous sulfate added to 25 g of 20% (weight/volume ) AC, or 5 mg/kg ferrous sulfate added to a premixed slurry consisting of 8 g of DFO and 25 g of 20% (weight/volume) AC. The same group of v olunteers was used in each limb of the study. Serum iron concentration s were measured at baseline and at 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 hours after ingestion for all subjects. Urinary iron was determine d over the first 12 hours after ingestion for each limb. The maximum i ron concentration (Cmax), the time to maximum iron concentration (Tmax ), and the area under the curve (AUG) were compared for all three limb s. Results: The AUC (P=.042) and Cmax (P=.017) were significantly lowe r in all subjects in the DFO/AC limb compared with the two control lim bs. There was no significant difference in the Tmax iron concentration (P=.77). In the ferrous sulfate control limb, female volunteers had a significantly higher mean Cmax (P=.008) and AUC (P=.014) than males. Iron was undetectable in all baseline and 12-hour urine collections. C onclusion: In this model, a premixed 1:3(weight/weight) DFO/AC slurry reduced the GI absorption of ferrous sulfate in adult volunteers under physiologic conditions.