Drug reference

Deferiprone

Oral iron chelator (bidentate) · Treatment of iron overload

Also known as Ferriprox

START

25 mg/kg PO three times daily; titrate per iron burden

TYPICAL MAX

99 mg/kg/day (33 mg/kg TID)

STOP IF

ANC <500 (any febrile episode), grade ≥3 hepatic enzyme rise, or severe arthritis

WATCH

Weekly CBC (mandatory) — boxed agranulocytosis; LFTs, ferritin/cardiac MRI T2*

CDSCO approvedATC V03AC02

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 30min · absorption
PEAK: 1.5h · Tmax
t½: 2h · t½
DURATION: 8h · TID

EXCRETION

Mainly renal — glucuronide / Fe complex

route + CYP

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Contraindicated — animal teratogenicity.

FDA category + note

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Mechanism

Bidentate iron chelator that binds ferric iron (Fe³⁺) in a 3:1 complex, mobilising iron from intracellular stores (especially cardiac myocytes) and promoting urinary excretion; useful for cardiac iron overload in transfusion-dependent thalassaemia.

Indications

Transfusional iron overload in thalassaemia syndromes (when other chelators inadequate or contraindicated)

Dosing

Adult: 25–33 mg/kg PO three times daily (75–99 mg/kg/day); typical maintenance ~75 mg/kg/day. Dose-banded BID regimens (50 mg/kg BID) also approved.
Pediatric: Children ≥6 y per weight (specialist).
Renal adjustment: Caution in significant impairment; no fixed adjustment.
Hepatic adjustment: Caution; reduce if significant.
Geriatric: Standard adult dosing; monitor closely.
Max dose: 99 mg/kg/day (33 mg/kg TID)

Pharmacokinetics

Onset

Chelation within hours

Peak effect

~1–2 h (Tmax)

Duration

~8 h (TID dosing)

Half-life

~2 h

Bioavailability

Well absorbed orally

Protein binding

~10%

Metabolism

Hepatic glucuronidation

Excretion

Mainly renal (~85% as glucuronide / iron complex)

Contraindications

History of agranulocytosis with deferiprone
Severe hypersensitivity
Pregnancy (animal teratogenicity)

Side effects

Common

Nausea/vomitingAbdominal painArthralgia / joint painChromaturia (red-brown urine)Increased ALT

Serious

Agranulocytosis / severe neutropenia (boxed)
Hepatotoxicity
Severe arthropathy
Zinc deficiency

Pregnancy & lactation

Pregnancy

Contraindicated — animal teratogenicity.

Lactation

Avoid breastfeeding during therapy.