Deferiprone

Indications

Deferiprone is used for: Thalassaemia, Iron overload

Adult Dose

Transfusional Iron Overload Iron chelator indicated for treatment of transfusional iron overload caused by thalassemia syndromes when current chelation therapy is inadequate 25-33 mg/kg PO TID (ie, total daily dosage range 75-99 mg/kg/day) Round dose to nearest 250 mg

Child Dose

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Agranulocytosis, pregnancy and lactation.

Precautions

Hepatic and renal impairment. Neutropenia, monitor neutrophil count wkly and discontinue treatment if neutropenia develops. Limited experience in children 6-10 yr. Lactation: Unknown whether distributed in breast milk; because of the potential for adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

Pregnancy-Lactation

Pregnancy Limited available data with use in pregnant women are insufficient to inform a drug-associated risk of major birth defects and miscarriage Verify the pregnancy status of females of reproductive potential prior to initiating therapy Contraception Females: Advise females of reproductive potential to avoid pregnancy during treatment and 6 months of contraception is recommended after cessation of therapy; advise females to immediately report pregnancy Males: Advise males with female sexual partners of reproductive potential to use effective contraception during treatment and 3 months of contraception is recommended after cessation of therapy Lactation There is no information regarding the presence of deferiprone in human milk, the effects on the breastfed child, or the effects on milk production Because of the potential for serious adverse reactions, including the potential for tumorigenicity shown for deferiprone in animal studies, advise not to breastfeed during treatment and for 2 weeks after last dose

Interactions

Avoid using deferiprone with aluminium-containing antacids as it can chelates trivalent metal ions.

Adverse Effects

Side effects of Deferiprone : >10% Chromaturia (14.6%), Nausea (12.6%), Abdominal pain/discomfort (10.4%) 1-10% Arthralgia (9.8%), Vomiting (9.8%), Increased ALT (7.5%), Decreased neutrophil count (7.3%), Neutropenia (6.2%), Increased appetite (4%), Diarrhea (3%), Headache (2.5%), Dyspepsia (2%), Back pain (2%), Extremity pain (1.9%), Increased weight (1.9%), Agranulocytosis (1.7%), Arthropathy (1.4%), Increased AST (1.2%), Decreased appetite (1.1%)

Mechanism of Action

Deferiprone is an orally effective iron-chelating agent. It is being used when desferrioxamine is unsuitable or contraindicated.