Drug Interactions between deferiprone and mercaptopurine
This report displays the potential drug interactions for the following 2 drugs:
- deferiprone
- mercaptopurine
Interactions between your drugs
mercaptopurine deferiprone
Applies to: mercaptopurine 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. Serious infection and death have been reported. The mechanism by which deferiprone leads to neutropenia or agranulocytosis is unknown. In pooled clinical trials of 642 patients with thalassemia syndromes, neutropenia occurred in 6.2% and agranulocytosis in 1.7% of deferiprone-treated patients. Similarly, agranulocytosis occurred in 1.5% of deferiprone-treated patients in pooled clinical trials of 196 patients with sickle cell disease or other anemias. Pediatric patients experienced a higher rate of decreases in neutrophil count when compared to adults being treated with deferiprone for the same condition. Neutropenia and agranulocytosis generally resolve upon discontinuation of deferiprone.
MANAGEMENT: Concomitant use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis should generally be avoided. Some authorities consider this combination to be contraindicated. If coadministration is unavoidable, the patient's baseline absolute neutrophil count (ANC) should be measured and then closely monitored during deferiprone therapy according to the manufacturer's product labeling. If neutropenia or infection develops, deferiprone and any other concomitant therapy associated with neutropenia or agranulocytosis should be discontinued. A complete blood cell (CBC) count, including a white blood cell (WBC) count corrected for the presence of nucleated red blood cells, an ANC, and a platelet count should be obtained daily until recovery. Patients should be advised to seek immediate medical assistance if they develop symptoms of infection (e.g., fever, sore throat, flu-like symptoms). 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.
References
- (2023) "Product Information. Ferriprox (deferiprone)." Chiesi Ltd
- (2022) "Product Information. Ferriprox (deferiprone)." Apotex Pty Ltd, 2.0
- (2023) "Product Information. Ferriprox MR (deferiprone)." Chiesi Canada Corp
- (2023) "Product Information. Ferriprox (deferiprone)." Chiesi USA, Inc
Drug and food interactions
mercaptopurine food
Applies to: mercaptopurine
ADJUST DOSING INTERVAL: Limited data suggest that food may decrease the oral bioavailability of 6-mercaptopurine (6-MP). In one study, the pharmacokinetics of 6-MP were studied on two separate occasions in seven patients. A single dose of 6-MP was administered after an overnight fast on one occasion and 15 minutes after a standard breakfast on the other. The authors reported that peak plasma levels of 6-MP were lower and took longer to reach following administration in the fed state. In addition, plasma levels were undetectable (less than 20 ng/mL) in two patients.
MANAGEMENT: Until more information is available regarding the effect of food on 6-MP absorption, it may be advisable to take 6-MP on an empty stomach 1 hour before or 2 hours after a meal.
References
- Schmidt LE, Dalhoff K (2002) "Food-drug interactions." Drugs, 62, p. 1481-502
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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