Drug interactions between anakinra and deferiprone

anakinra ↔ deferiprone

Applies to:anakinra and deferiprone

GENERALLY AVOID: Coadministration of deferiprone and other drugs that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity. Deferiprone alone can cause agranulocytosis, which may be preceded by neutropenia. In pooled clinical trials, neutropenia occurred in 6.2% and agranulocytosis in 1.7% of deferiprone-treated patients. Although neutropenia and agranulocytosis usually resolve upon discontinuation of deferiprone, there have been reports of agranulocytosis leading to serious infections and death.

MANAGEMENT: Concomitant use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis should generally be avoided. Otherwise, close monitoring of absolute neutrophil count (ANC) is recommended if coadministration is required. The ANC should be measured prior to initiating deferiprone and weekly during therapy. The manufacturer recommends that treatment be interrupted if neutropenia (ANC between 0.5 and 1.5 x 10^9/L) or infection develops. Patients should be advised to immediately discontinue deferiprone as well as all other medications with a potential to cause neutropenia and seek medical attention if they experience symptoms indicative of infection such as fever, sore throat, and flu-like symptoms. A complete blood cell (CBC) count, including a white blood cell (WBC) count corrected for the presence of nucleated red blood cells, an absolute neutrophil count (ANC), and a platelet count should be obtained daily until recovery. For patients who develop agranulocytosis (ANC less than 0.5 x 10^9/L), hospitalization should be considered, and deferiprone should not be resumed following recovery unless potential benefits outweigh the risks. Likewise, patients who develop neutropenia with deferiprone should not be rechallenged unless potential benefits outweigh the risks.