Deferiprone is an oral iron chelator used primarily for the treatment of chronic iron overload due to blood transfusions in patients with thalassemia major and other transfusion-dependent anemias. It is a bidentate hydroxypyridinone derivative that binds to ferric iron (Fe3+) with high affinity, forming a stable 3:1 complex (deferiprone:iron) that is excreted in urine. It is a crucial medication in the Indian context for managing transfusion-induced hemosiderosis, offering an oral alternative to parenteral desferrioxamine.
Adult: 25 mg/kg body weight, orally, three times daily (75 mg/kg/day total). Tablets should be swallowed whole with water.
Note: Take on an empty stomach (1 hour before or 2 hours after meals) to maximize absorption. If gastrointestinal upset occurs, may be taken with a small, low-iron meal (e.g., toast, plain rice). Do not crush or chew tablets. Maintain consistent dosing intervals.
Deferiprone is a lipid-soluble, bidentate chelator that selectively binds trivalent iron (Fe3+). It penetrates cell membranes, including those of hepatocytes and myocardial cells, to access intracellular labile iron pools. It forms a stable, neutral 3:1 (ligand:iron) complex, which is water-soluble and excreted via the kidneys.
Pregnancy: Category C (US FDA). Animal studies show teratogenicity. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Iron chelation is generally avoided during pregnancy unless severe iron overload is life-threatening.
Driving: Deferiprone is not known to impair driving ability. However, patients experiencing side effects like dizziness or arthralgia should exercise caution.
| Antacids containing Aluminium/Magnesium | May decrease absorption of deferiprone. Separate administration by at least 4 hours. | Moderate |
| Vitamin C (high dose >200mg/day) | May increase iron mobilization and tissue toxicity, particularly cardiac. Avoid concomitant use. | Major |
| Ursodeoxycholic Acid | May increase the bioavailability of deferiprone. Monitor for increased adverse effects. | Moderate |
| Probenecid | May inhibit renal excretion of deferiprone glucuronide, increasing plasma levels. | Moderate |
| Myelosuppressive drugs (e.g., Clozapine, Chemotherapy) | Increased risk of neutropenia/agranulocytosis. Extreme caution and frequent monitoring required. | Major |
| Other Iron Chelators (Deferoxamine, Deferasirox) | Used in combination therapy under specialist supervision; may have synergistic effects but also increased risk of adverse events. | Major |