deferiprone (Oral route)

de-FER-i-prone

Oral route(Tablet)

Deferiprone can cause agranulocytosis, often preceded by neutropenia, that can lead to serious infections and death. Measure the absolute neutrophil count (ANC) before starting deferiprone therapy and weekly on therapy. Interrupt deferiprone therapy if neutropenia or infection develops and monitor the ANC more frequently. Advise patients to report immediately any symptoms indicative of infection .

Commonly used brand name(s)

In the U.S.

  • Ferriprox

Available Dosage Forms:

  • Tablet

Therapeutic Class: Heavy Metal Chelator

Uses For deferiprone

Deferiprone is used to remove excess iron from the body in thalassemia patients who have blood transfusions.

Deferiprone combines with iron in the blood. The combination of iron and deferiprone is then removed from the body by the kidneys. If you have too much iron in the body, it can damage various organs and tissues.

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deferiprone is available only with your doctor's prescription.

Before Using deferiprone

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For deferiprone, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to deferiprone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of deferiprone in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies have not been performed on the relationship of age to the effects of deferiprone in the geriatric population. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving deferiprone.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking deferiprone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using deferiprone with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Diclofenac
  • Phenylbutazone
  • Probenecid
  • Silymarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of deferiprone. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood or bone marrow problems (e.g., agranulocytosis, neutropenia) or
  • Heart rhythm problems (e.g., QT prolongation), history of or
  • Liver disease—Use with caution. May make these conditions worse.
  • Congestive heart failure or
  • Heart disease or
  • Heart rhythm problems (e.g., slow heartbeat) or
  • Hypokalemia (low potassium in the blood) or
  • Hypomagnesemia (low magnesium in the blood)—Use with caution. May increase risk for more serious side effects.
  • Infection—May decrease your body's ability to fight infection.

Proper Use of deferiprone

Take deferiprone only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

deferiprone comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

It is best to take the first dose of deferiprone in the morning, the second dose at midday, and the third dose in the evening with meals unless your doctor tells you otherwise.

If you are taking antacids, multivitamins, or supplements containing aluminum, iron, and zinc, take these medicines at least 4 hours before or after taking deferiprone.

Dosing

The dose of deferiprone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of deferiprone. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For chronic iron overload:
      • Adults—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 25 milligrams (mg) per kilogram (kg) of body weight, three times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 99 mg per kg per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of deferiprone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using deferiprone

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Using deferiprone while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Deferiprone can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

Stop using deferiprone and check with your doctor right away if you start to have a cough that won't go away, weight loss, night sweats, a fever, chills, or flu-like symptoms, such as a runny or stuffy nose, headache, blurred vision, or feeling generally ill. These may be signs that you have an infection.

deferiprone can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or uneven heartbeats.

deferiprone may cause your urine to turn red or brownish in color. This is normal and is nothing to worry about.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

deferiprone Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Black, tarry stools
  • chills
  • cough
  • fever
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • shortness of breath
  • sore throat
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Less common
  • Fever with or without chills
  • general feeling of tiredness or weakness
  • hoarseness
Incidence not known
  • Abdominal or stomach pain
  • anxiety
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • blurred vision
  • chest pain or discomfort
  • clay-colored stools
  • confusion
  • convulsions
  • dark urine
  • decreased urination
  • dilated neck veins
  • dizziness or lightheadedness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • extreme fatigue
  • fainting
  • fast or irregular heartbeat
  • headache
  • hives
  • increase in heart rate
  • increased sweating
  • irregular breathing
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • large, flat, blue or purplish patches in the skin
  • loss of appetite
  • muscle tremors
  • nausea
  • nervousness
  • painful knees and ankles
  • pinpoint red spots on the skin
  • pounding in the ears
  • raised red swellings on the skin, the buttocks, legs, or ankles
  • rapid weight gain
  • rapid, deep breathing
  • rapid, shallow breathing
  • rash
  • redness of the skin
  • restlessness
  • severe nausea or vomiting
  • slow heartbeat
  • sneezing
  • spots on your skin resembling a blister or pimple
  • stomach cramps
  • sudden shortness of breath or troubled breathing
  • sugar in the urine
  • sunken eyes
  • sweating
  • swelling around the eyes
  • swelling of the eyelids, face, lips, hands, or feet
  • thirst
  • tightness in the chest
  • tingling of the hands or feet
  • trouble with balance
  • troubled breathing or swallowing
  • unpleasant breath odor
  • unusual weight gain or loss
  • vision changes
  • vomiting of blood
  • weight gain
  • wheezing
  • wrinkled skin
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Abdominal or stomach discomfort
  • difficulty with moving
  • muscle pain or stiffness
  • reddish or brow discoloration of the urine
Less common
  • Acid or sour stomach
  • back pain
  • belching
  • diarrhea
  • heartburn
  • increased or decreased appetite
  • indigestion
  • pain in the arms or legs
  • stomach upset
Incidence not known
  • Bloody nose
  • clenching, gnashing, or grinding teeth
  • constipation
  • coughing or spitting up blood
  • depression
  • difficulty opening the mouth
  • difficulty with speaking
  • drooling
  • hives or welts
  • impaired psychomotor skills
  • increased sensitivity of the skin to sunlight
  • lockjaw
  • loss of appetite
  • loss of balance control
  • muscle spasm, especially of the neck and back
  • muscle trembling, jerking, or stiffness
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • redness or other discoloration of the skin
  • restlessness
  • severe sunburn
  • shuffling walk
  • sleepiness or unusual drowsiness
  • stiffness of the limbs
  • stomach bloating, burning, cramping, or pain
  • twisting movements of the body
  • uncontrolled movements, especially of the face, neck, and back

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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