Adult Dosing
Chronic transfusional iron overload
- Initial dose: 25 mg/kg PO tid (75 mg/kg/day)
- Max: 33 mg/kg tid (99 mg/kg/day)
- Round dose to the nearest 250 mg (half-tablet)
Note:
- Examine serum ferritin concentration every 2-3 months to evaluate the effects on body iron stores
- Dose adjustments should be modified to the individual patient’s response and therapeutic goals
- Consider interrupting treatment temporarily if serum ferritin falls consistently <500 mcg/L
- Interrupt therapy if ANC <1500
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Therapy may cause fatal agranulocytosis and neutropenia. Monitor the absolute neutrophil count (ANC) before initiating therapy and weekly thereafter
- Interrupt therapy if neutropenia (ANC <1.5×109/L) or infection develops
- If neutropenia occurs, discontinue therapy immediately and all other medications with a potential to cause neutropenia; monitor CBC, WBC, ANC, and platelets daily until recovery
- Consider hospitalization and other appropriate therapy as indicated for agranulocytosis. Do not restart therapy in patients who have developed agranulocytosis unless potential benefits outweigh potential risks
- Instruct patients receiving deferiprone to report to their physician immediately if they experience symptoms such as palpitations, dizziness, lightheadedness, syncope, or seizures
- Therapy may cause fetal harm when administered to a pregnant woman. Patients should be apprised of the potential hazard to the fetus if therapy is used during pregnancy or if the patient becomes pregnant while taking deferiprone
- Monitor serum ALT levels monthly during therapy and consider interruption if there is a persistent increase in serum transaminase levels. Evaluate plasma zinc concentration, and supplement in the event of a deficiency
Caution: Use cautiously in:
Supplemental Patient Information
- Inform patients of the risks of developing agranulocytosis and instruct them to immediately interrupt therapy
- Advise patients to promptly report to their physician if they experience any symptoms of infection such as fever, sore throat or flu-like symptoms
- Inform patients that their urine might show a brown/reddish discoloration due to the excretion of iron-deferiprone complex
- Advise patients to immediately notify their physician if they become pregnant or if they plan to become pregnant during therapy
- Instruct patients to immediately seek medical attention if they experience symptoms such as palpitations, dizziness, syncope, lightheadedness, or seizures
Pregnancy Category:D
Breastfeeding: Safety unknown. Since many drugs are excreted in human milk and due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, analyzing the importance of the drug to the mother.
