deferiprone

Contraindicated in:

Hypersensitivity;
OB: Pregnancy;
Lactation: Lactation .

Use Cautiously in:

Pedi: Children <8 yr (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: TORSADES DE POINTES

GI: abdominal pain, nausea, ↑liver enzymes, change in appetite, vomiting

GU: chromaturia

Hemat: AGRANULOCYTOSIS, neutropenia

MS: arthralgia, arthropathy, back pain, extremity pain

Neuro: headache

Misc: ↓zinc levels

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of other drugs that cause neutropenia/agranulocytosis may ↑ risk of neutropenia/agranulocytosis.
May also chelate other concurrently administered polyvalent cations in mineral supplements and antacids, including iron, aluminum, and zinc; wait 4 hr between administration.

Availability ⬆ ⬇

(Generic available)

Oral solution bubble gum flavor: 100 mg/mL
Tablets: 500 mg; 1000 mg (for twice daily administration); 1000 mg (for 3 times daily administration)

Route/Dosage ⬆ ⬇

Twice Daily Regimen

PO (Adults and Children ≥8 yr): 1000-mg tablet (for twice daily administration): 37.5 mg/kg (actual body weight) every 12 hr; may be adjusted up to 49.5 mg/kg (actual body weight) every 12 hr. Dose should be rounded to the nearest 1/2 tablet (500 mg).

Three Times Daily Regimen

PO (Adults and Children ≥8 yr): 500-mg tablet, 1000-mg tablet (for 3 times daily administration), or oral solution: 25 mg/kg (actual body weight) 3 times daily; may be adjusted up to 33 mg/kg (actual body weight) 3 times daily. Dose should be rounded to the nearest 1/2 tablet or the nearest 2.5 mL.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Bonds with ferric ions to form neutral complexes, which are then eliminated.

Therapeutic effects:

Decrease in iron overload as reflected in decreased ferritin levels.

Classifications ⬆ ⬇

Therapeutic Classification: antidotes

Pharmacologic Classification: chelating agents

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration.

Distribution: Widely distributed to extravascular tissues.

Metabolism/Excretion: Mostly metabolized (by UGT1A6 enzyme system); 75–90% excreted in urine as metabolites.

Half-Life: 1.9 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	within 5–10 min	1–2 hr	8–12 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient to take deferiprone as directed. Take missed doses as soon as remembered, but not just before next dose. Do not double doses. Advise patient to read Medication Guide before starting with each Rx refill in case of changes.
Advise patient to stop therapy and notify health care provider immediately if signs and symptoms of infection (fever, sore throat) or if palpitations, dizziness, syncope, or seizures occur.
Inform patient that reddish/brown urine may occur; common and not harmful.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications. Instruct patient to allow ≥4 hr between deferiprone and mineral supplements and antacids that contain iron, aluminum, or zinc.
Rep: May cause fetal harm. Advise women of reproductive potential to use effective contraception during therapy and for ≥6 mo after last dose and avoid breastfeeding during therapy and for ≥2 wk after last dose. Advise men with female partners of reproductive potential to use effective contraception during therapy and for ≥3 mo after last dose. If pregnancy is planned or suspected, notify health care provider promptly.

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Indications ⬇

Contraind./Precautions ⬆ ⬇