Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Vitamin C therapy given during your chelation therapy can increase the amount of iron your body excretes; however, high dosages of vitamin C can result in iron damaging your heart.
What might happen:
High dosages of vitamin C can result in iron damaging your heart.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may instruct you to limit your vitamin C intake and/or only take it when you receive your iron chelation therapy. Your doctor may want to perform tests to monitor your heart.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Roeser HP. The role of ascorbic acid in the turnover of storage iron. Semin Hematol 1983 Apr;20(2):91-100.
2.Desferal (deferoxamine mesylate) US prescribing information. Novartis Pharmaceuticals Corporation December, 2011.
3.Nienhuis AW, Delea C, Aamodt R, Bartter F, Anderson WF. Evaluation of desferrioxamine and ascorbic acid for the treatment of chronic iron overload. Birth Defects Orig Artic Ser 1976;12(8):177-85.
4.O'Brien RT. Ascorbic acid enhancement of desferrioxamine-induced urinary iron excretion in thalassemia major. Ann N Y Acad Sci 1974;232(0):221-5.
5.Hussain MA, Green N, Flynn DM, Hoffbrand AV. Effect of dose, time, and ascorbate on iron excretion after subcutaneous desferrioxamine. Lancet 1977 May 7;1(8019):977-9.
6.Conte D, Brunelli L, Ferrario L, Mandelli C, Quatrini M, Velio P, Bianchi PA. Effect of ascorbic acid on desferrioxamine-induced urinary iron excretion in idiopathic hemochromatosis. Acta Haematol 1984;72(2):117-20.
7.Ambruso DR, Mahony BS, Githens JH, Rhoades ED. Effect of subcutaneous deferoxamine and oral vitamin C on iron excretion in congenital hypoplastic anemia and refractory anemia associated with the 5q-syndrome. Am J Pediatr Hematol Oncol 1982 Summer;4(2):115-23.
8.Wapnick AA, Lynch SR, Charlton RW, Seftel HC, Bothwell TH. The effect of ascorbic acid deficiency on desferrioxamine-induced urinary iron excretion. Br J Haematol 1969 Dec;17(6):563-8.
9.Cohen A, Schwartz E. Iron chelation therapy with deferoxamine in Cooley anemia. J Pediatr 1978 Apr;92(4):643-7.
10.Thalassemia major: molecular and clinical aspects. NIH Conference. Ann Intern Med 1979 Dec;91(6):883-97.
11.McLaran CJ, Bett JH, Nye JA, Halliday JW. Congestive cardiomyopathy and haemochromatosis--rapid progression possibly accelerated by excessive ingestion of ascorbic acid. Aust N Z J Med 1982 Apr;12(2):187-8.
12.Rowbotham B, Roeser HP. Iron overload associated with congenital pyruvate kinase deficiency and high dose ascorbic acid ingestion. Aust N Z J Med 1984 Oct;14(5):667-9.
13.Schafer AI, Rabinowe S, Le Boff MS, Bridges K, Cheron RG, Dluhy R. Long-term efficacy of deferoxamine iron chelation therapy in adults with acquired transfusional iron overload. Arch Intern Med 1985 Jul; 145(7):1217-21.