Deferiprone

Introduction

Deferiprone is an iron chelator used to treat iron overload, primarily in patients with thalassemia major or other chronic anemias that require frequent blood transfusions. By binding excess iron, Deferiprone helps prevent the complications of iron overload, such as damage to the heart, liver, and endocrine organs.

Uses

Deferiprone is primarily used for:

Treatment of transfusional iron overload in patients with thalassemia major
Alternative treatment for patients with iron overload due to sickle cell disease or other chronic anemias
Used in cases where other iron chelators, such as deferoxamine, are ineffective or contraindicated

Brand Name	Deferiprone
Type
Weight
Generic	Deferiprone
Manufacturer
Available in	English বাংলা

Mechanism of Action

Deferiprone binds to excess free iron (Fe³⁺) in the blood and cells to form a stable complex that is excreted primarily through urine. This helps reduce the iron burden in tissues and organs, preventing damage caused by iron toxicity.

How Long Does It Take to Work?

The effects of Deferiprone on iron levels can be observed within a few weeks, but significant reductions in total body iron may take several months of continuous use.

Absorption

Deferiprone is rapidly absorbed from the gastrointestinal tract, reaching peak plasma concentrations approximately 1 to 2 hours after oral administration.

Route of Elimination

Deferiprone is metabolized primarily in the liver, and the iron-Deferiprone complex is excreted primarily via the kidneys in the urine.

Dosage

In adults and children over 6 years: this medicine may be given by mouth in doses of 25mg/kg three times daily. Doses above 100mg/kg daily are not recommended. Or, as directed by the registered physician.

The recommended dosage of Deferiprone is:

Starting dose: 25 mg/kg of body weight, three times daily (total daily dose of 75 mg/kg)
Doses can be adjusted up to 100 mg/kg per day based on patient needs and response.
Dosage adjustments may be required based on ferritin levels and individual response.

Administration

Deferiprone is administered orally in tablet or liquid form.
It should be taken with or without food, though taking with food can reduce gastrointestinal side effects.
Follow your healthcare provider’s instructions on the timing of doses to maintain optimal drug levels in the blood.

Side Effects

Nausea and vomiting
Abdominal pain
Diarrhea
Joint pain (arthralgia)
Elevated liver enzymes
Neutropenia or agranulocytosis (rare but serious reduction in white blood cells)
Reddish-brown discoloration of urine (due to excreted iron)

Toxicity

Deferiprone has a narrow therapeutic index, meaning close monitoring is required to avoid serious side effects, such as neutropenia (low white blood cell count) or agranulocytosis. Regular blood tests are essential to monitor for these effects, especially in the early stages of treatment.

Precautions

Frequent monitoring of blood counts is required due to the risk of agranulocytosis and neutropenia.
Patients with liver disease should use Deferiprone with caution due to the potential for elevated liver enzymes.
Patients should be advised to report symptoms of infection (fever, sore throat) immediately, as these could be signs of neutropenia.

Interaction

Concomitant use of Deferiprone with drugs that affect neutrophil counts (e.g., clozapine) should be avoided.
Taking with antacids containing aluminum may reduce the absorption of Deferiprone .
Combining with other iron chelators should be done only under medical supervision.

Disease Interaction

Deferiprone should be used cautiously in patients with a history of liver disease or elevated liver enzymes.
Patients with a history of neutropenia or other blood disorders should be carefully monitored during treatment.

Drug Interaction

Drugs that suppress bone marrow function (e.g., clozapine) may increase the risk of agranulocytosis.
Antacids containing aluminum or magnesium may interfere with the absorption of Deferiprone .
Other iron chelation therapies (e.g., deferasirox, deferoxamine) may have additive effects when used with Deferiprone .

Food Interactions

Deferiprone can be taken with or without food. However, taking it with food may reduce gastrointestinal side effects, such as nausea.

Pregnancy Use

Deferiprone is classified as a pregnancy category D drug, indicating potential risk to the fetus. It should only be used during pregnancy if the potential benefit justifies the risk to the fetus. Women of childbearing potential should use effective contraception while on Deferiprone .

Lactation Use

It is not known whether Deferiprone is excreted in human breast milk. Due to the potential for serious adverse reactions in nursing infants, breastfeeding is not recommended while using Deferiprone .

Acute Overdose

Overdose of Deferiprone can lead to severe gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, and may result in iron depletion. In cases of overdose, supportive care and monitoring of blood counts and liver function are required.

Contraindication

Hypersensitivity to Deferiprone or any of its components
Patients with a history of recurrent episodes of agranulocytosis or neutropenia
Pregnant women, unless absolutely necessary

Use Direction

Take Deferiprone exactly as prescribed by your healthcare provider.
Continue taking the medication even if you feel well; do not stop without consulting your doctor.
Attend regular check-ups to monitor iron levels, blood counts, and liver function.

Storage Conditions

Store Deferiprone at room temperature (15-30°C or 59-86°F).
Keep it in a dry place, away from moisture and direct heat.
Keep out of reach of children.

Volume of Distribution

Deferiprone has a moderate volume of distribution, as it is distributed throughout the body, including organs affected by iron overload, such as the liver and heart.

Half-Life

The half-life of Deferiprone is approximately 2-3 hours, meaning that it needs to be taken multiple times a day to maintain effective levels in the body.

Clearance

Deferiprone is primarily cleared through the kidneys, with the iron-Deferiprone complex excreted in urine. Some amount of Deferiprone is also metabolized in the liver and excreted through bile.

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