Deferiprone: Brands, Price & Uses in Bangladesh

Deferiprone is an oral iron chelator used to reduce chronic iron overload.

Established / approved uses

• Transfusional iron overload due to thalassemia syndromes (thalassemia major) — Deferiprone is indicated in adults and children when current chelation therapy (e.g., deferoxamine) is inadequate or contraindicated.
• Transfusional iron overload due to sickle cell disease or other anemias — Deferiprone is approved for this use in patients whose prior chelation therapy is inadequate.

Not established

The safety and efficacy of Deferiprone have not been established for iron overload due to myelodysplastic syndrome or Diamond-Blackfan anemia, and it should not be used for these conditions outside of a specialist/clinical-trial setting.

Deferiprone is generally reserved as second-line therapy and, in some regimens, is used in combination with deferoxamine under specialist supervision for patients with severe iron overload.

Adults and children 8 years and older (as per approved labeling)

Dose is individualized and adjusted based on serum ferritin trends and clinical response. In some national labels (including Bangladesh), Deferiprone is dosed as 25 mg/kg three times daily (75 mg/kg/day) in patients above 6 years of age, up to a maximum of 100 mg/kg/day, when deferoxamine therapy is inadequate or contraindicated; the treating physician's local label and monitoring protocol should be followed.

Renal or hepatic impairment

Dedicated dose-adjustment studies are lacking. Deferiprone should be used with caution and close monitoring in patients with hepatic impairment (see Precautions) and is not recommended in patients with significant renal impairment unless benefit clearly outweighs risk, under specialist supervision.

Administration

Deferiprone tablets are usually taken with meals to reduce gastrointestinal upset, swallowed whole with water; the oral solution (where available) should be measured with the supplied dosing device. Doses should be spaced evenly through the day. Do not take iron- or mineral-containing supplements (e.g., antacids, zinc, or iron products) within 4 hours of a dose (see Interactions).

Common

• Nausea, vomiting, abdominal pain
• Joint pain (arthralgia)
• Elevated liver enzymes (ALT)
• Reddish-brown discoloration of urine (chromaturia) — a harmless, expected effect of iron excretion
• Headache

Serious (see Precautions and Warnings for full detail)

• Neutropenia and agranulocytosis (potentially fatal — requires immediate discontinuation and evaluation)
• Zinc deficiency
• Hepatic fibrosis (rare, reported with long-term use)

In patients treated for sickle cell disease or other anemias, fever, bone/back pain, sickle cell crisis, sore throat, and upper respiratory infection have also been reported with Deferiprone.