Deferiprone

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Generic Name of Deferiprone - Learn More

Deferiprone

Deferiprone Precaution - What You Need to Know

Deferiprone is an iron-chelating agent used to treat iron overload conditions, such as thalassemia, by binding excess iron and promoting its excretion. Caution is needed in patients with pre-existing liver or kidney conditions, as these organs play a crucial role in the drug’s metabolism and elimination. Hepatic and renal functions should be monitored regularly during therapy. Deferiprone is contraindicated in patients with a history of agranulocytosis (a severe decrease in white blood cells), as the drug is associated with an increased risk of this condition. It should be avoided in pregnancy unless the potential benefits outweigh the risks, and it is not recommended during breastfeeding due to the unknown effects on the infant. Regular monitoring of blood counts, including white blood cell and neutrophil counts, is essential during treatment to detect any signs of neutropenia or agranulocytosis early. Furthermore, caution is advised when using deferiprone with other medications that may increase the risk of neutropenia or when used with medications that impact the kidney or liver function. Patients should also avoid overuse of iron-rich supplements or vitamin C during deferiprone therapy, as excessive iron can overwhelm the chelation process.

Deferiprone Indication - Uses and Benefits

Deferiprone is primarily indicated for the treatment of chronic iron overload in patients with thalassemia major and other conditions that require regular blood transfusions. Chronic transfusion therapy leads to excessive iron accumulation in the body, and deferiprone works by binding to free iron and facilitating its excretion through urine. The drug is often used when other chelation therapies, such as deferoxamine or deferasirox, are ineffective or not well tolerated. Clinical studies have shown that deferiprone is effective in reducing serum ferritin levels and improving the clinical outcomes of patients with iron overload, reducing the risk of complications like liver cirrhosis, heart failure, and diabetes. Off-label uses of deferiprone may include the treatment of iron overload due to other causes, such as hemochromatosis, although it is more commonly used in thalassemia management. It is a valuable alternative for patients who have not responded adequately to other chelation therapies or who have experienced intolerable side effects with first-line agents.

Deferiprone Contraindications - Important Warnings

Deferiprone is contraindicated in patients with a history of hypersensitivity to the drug or any of its components. It should not be used in individuals with a history of agranulocytosis, as this adverse effect can be fatal and is a well-documented risk associated with the drug. Deferiprone is also contraindicated in patients with severe liver or renal dysfunction due to the potential for further exacerbation of these conditions. Patients with active infections or conditions that predispose to infections should avoid using deferiprone, as its effects on white blood cell counts can increase susceptibility to infections. Pregnancy and breastfeeding are also contraindications for deferiprone use. The drug’s effects on the fetus are unknown, and it is excreted in breast milk, potentially affecting the infant. Deferiprone should be avoided in children under 2 years of age due to safety concerns and lack of sufficient clinical data regarding its use in this age group.

Deferiprone Side Effects - What to Expect

Common side effects of deferiprone include gastrointestinal disturbances such as nausea, vomiting, abdominal pain, and diarrhea. These effects can be minimized by taking the drug with food or dividing doses into smaller amounts throughout the day. The most serious side effect associated with deferiprone is agranulocytosis, a severe reduction in white blood cell counts that can increase the risk of infections. This is a dose-dependent side effect, so regular blood monitoring is crucial to detect early signs of neutropenia. Other hematologic side effects include neutropenia and thrombocytopenia, which also necessitate frequent blood tests. Less common but significant side effects may include liver toxicity, including elevated liver enzymes, jaundice, and hepatic dysfunction. If liver function tests are abnormal, dose reduction or discontinuation may be required. Some patients may also experience joint pain, dizziness, or skin rash. Long-term use may lead to musculoskeletal problems or a higher incidence of infection, particularly if the patient has pre-existing immunocompromised conditions. To mitigate these side effects, patients should undergo regular monitoring of blood counts, liver function, and kidney function during treatment. Any signs of infection or abnormal laboratory findings should prompt immediate medical intervention.

Deferiprone Pregnancy Category ID - Safety Information

4

Deferiprone Mode of Action - How It Works

Deferiprone acts as a selective iron chelator, binding to free ferric iron (Fe3+) and forming a stable complex that is then excreted primarily in the urine. Unlike other iron chelators, which may have a broader range of binding properties, deferiprone specifically targets and chelates excess iron, thereby reducing the overall iron burden in tissues such as the liver, heart, and endocrine organs. Iron is an essential element for cellular function, but excess iron can lead to tissue damage due to oxidative stress, which is a major cause of the complications seen in iron overload disorders. By removing excess iron, deferiprone helps to prevent these complications, including liver cirrhosis, heart failure, and diabetes. Deferiprone’s mechanism is distinct from other chelators, such as deferoxamine, in that it is a small molecule with good oral bioavailability, allowing for convenient oral administration. Its chelation action is dose-dependent, and the efficiency of the drug can vary based on the degree of iron overload in the patient.

Deferiprone Drug Interactions - What to Avoid

Deferiprone interacts with several medications that can influence its efficacy or increase the risk of adverse effects. For example, it can interact with other iron chelators such as deferoxamine or deferasirox, which may lead to additive effects and increased risk of toxicity if combined without appropriate adjustments. Co-administration with medications that affect white blood cell or neutrophil counts, such as certain chemotherapy agents or immunosuppressants, should be approached with caution due to the increased risk of neutropenia and agranulocytosis. The use of deferiprone with drugs that alter renal or hepatic function, such as nephrotoxic or hepatotoxic medications, can exacerbate these effects, leading to complications. Patients taking deferiprone should avoid high doses of vitamin C or iron supplements, as these can overload the chelation process and potentially lead to iron toxicity. There are also concerns that certain antibiotics, like ciprofloxacin or other quinolones, may interact with deferiprone and potentially affect its absorption or activity, although this interaction is generally considered moderate. To avoid potential interactions, it is important to carefully manage dosing schedules and monitor for any signs of adverse reactions.

Deferiprone Adult Dose - Recommended Dosage

For adult patients, the recommended dose of deferiprone is 75 mg/kg per day, divided into three equal doses (25 mg/kg per dose). This dosing regimen is typically used for the treatment of chronic iron overload in patients with thalassemia major who require regular blood transfusions. The maximum recommended dose is 100 mg/kg per day, but doses above 75 mg/kg may be associated with an increased risk of side effects, particularly agranulocytosis. Deferiprone should be taken orally, with or without food, although it is usually recommended to take it with food to minimize gastrointestinal side effects. Dosage adjustments may be necessary based on the patient’s response to therapy and tolerance, and it is important to regularly monitor blood counts, liver function, and kidney function during treatment. In cases of significant side effects, particularly hematologic toxicity, the dose may need to be reduced or the drug discontinued. The drug should be taken in divided doses, spaced evenly throughout the day.

Deferiprone Child Dose - Dosage for Children

For children with iron overload, the dosing of deferiprone is similar to that for adults but adjusted based on body weight. The recommended dose for pediatric patients is 75 mg/kg/day, divided into three equal doses. The maximum dose should not exceed 100 mg/kg/day. Deferiprone is usually administered to children with transfusion-dependent thalassemia or other conditions involving chronic iron overload. For children under the age of 2, deferiprone should not be used due to insufficient safety and efficacy data. In pediatric patients, regular monitoring of blood counts (including white blood cells), liver function, and kidney function is crucial, as children may be more sensitive to the hematologic side effects of the drug. Adjustments to the dose may be required based on clinical response and tolerance, and healthcare providers should monitor for any adverse reactions, particularly signs of infection or liver toxicity.

Deferiprone Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, deferiprone should be used with caution. While the drug is primarily metabolized by the liver, renal dysfunction may affect the elimination of the drug’s metabolites. In cases of moderate renal dysfunction, no specific dose adjustment is recommended, but regular monitoring of kidney function is essential. For patients with severe renal impairment (creatinine clearance below 30 mL/min), deferiprone should generally be avoided unless the benefits outweigh the risks. The drug should be discontinued in patients who develop signs of worsening renal function. Regular monitoring of creatinine levels and urine output is important for detecting any renal complications early. Deferiprone may be used in patients on dialysis, but extra caution is needed due to the potential for altered drug metabolism and increased toxicity.