Deferiprone
Indications
Deferiprone is an iron chelator (a medicine that binds and removes excess iron). It is used to treat iron overload in people who receive frequent blood transfusions, such as those with thalassaemia major, especially when other iron-removing medicines are unsuitable or not enough.
How It Works
Repeated blood transfusions add iron that the body cannot get rid of, and this iron can damage the heart, liver and hormone glands. Deferiprone attaches tightly to iron in the blood and tissues, including the heart, forming a complex that is passed out mainly in the urine.
Dosage and Administration
Deferiprone is taken by mouth, usually three times a day. The dose is worked out by the specialist according to body weight and iron levels, so take it exactly as prescribed. Taking it with food may reduce nausea. Regular blood tests are essential while taking it.
Interactions
- Medicines that can lower white blood cells, such as Clozapine, some anticancer medicines or Metamizole: avoid, as risk of agranulocytosis increases.
- Antacids or supplements containing aluminium, iron or zinc: take them at least 4 hours apart.
- Vitamin C supplements: use only as advised by the doctor.
Contraindications
- Allergy to Deferiprone.
- A history of agranulocytosis or repeated neutropenia (very low white blood cells).
- Current use of other medicines known to cause neutropenia.
- Pregnancy and breastfeeding.
Side Effects
Common side effects include nausea, vomiting, stomach pain, increased appetite, joint pain and swelling, raised liver tests, low zinc levels and a harmless red-brown colour of the urine. The most serious risk is a sudden fall in white blood cells (neutropenia or agranulocytosis), which leaves the body unable to fight infection.
Get urgent medical help, and stop taking the medicine until checked, if you develop fever, sore throat, mouth ulcers, flu-like symptoms or any sign of infection. Also seek help for signs of a severe allergic reaction.
Pregnancy and Lactation
Deferiprone may harm an unborn baby and must not be used in pregnancy. Women who could become pregnant must use effective contraception. Do not breastfeed while taking it.
Precautions and Warnings
- White blood cell counts are checked every week, or as directed, during treatment.
- Liver tests, zinc levels and iron (ferritin) levels are also monitored.
- Tell your doctor about kidney or liver problems or HIV infection.
Overdose
Long-term use of too high a dose has caused nerve and brain problems, such as unsteady walking, abnormal movements and vision changes. Seek medical help if too much is taken.
Therapeutic Class
Iron chelating agent.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Deferiprone