Drug Interactions between Copper and deferiprone

Fatal agranulocytosis and neutropenia can occur with the use of deferiprone. It is recommended to obtain an absolute neutrophil count before initiating treatment with deferiprone and monitor weekly thereafter or as clinically appropriate. Manage agranulocytosis/neutropenia prior to initiating treatment. Therapy should be interrupted if neutropenia develops or if an infection develops. Do not resume therapy in patients who have developed agranulocytosis and do not rechallenge patients who develop neutropenia unless potential benefits outweigh potential risks.

Fatal agranulocytosis and neutropenia can occur with the use of deferiprone. It is recommended to obtain an absolute neutrophil count before initiating treatment with deferiprone and monitor weekly thereafter or as clinically appropriate. Manage agranulocytosis/neutropenia prior to initiating treatment. Therapy should be interrupted if neutropenia develops or if an infection develops. Do not resume therapy in patients who have developed agranulocytosis and do not rechallenge patients who develop neutropenia unless potential benefits outweigh potential risks.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

A clinical study to evaluate the effect of impaired hepatic function on the pharmacokinetics of deferiprone showed that mild and moderate hepatic impairment do not influence the pharmacokinetics of deferiprone and major metabolite, deferiprone 3-O-glucuronide. Based on the results, no dose adjustment is required in patients with mildly or moderately hepatic impairment. Caution is recommended when using this agent in patients with severe hepatic impairment as the pharmacokinetics of deferiprone and deferiprone have not been evaluated. It is recommended to monitor serum transaminase values monthly during therapy and to consider interruption if there is a persistent increase in serum transaminase levels. Close monitoring is recommended.

The trace metals manganese, chromium, copper, selenium, and zinc are absorbed in the GI tract from dietary sources and following administration of oral supplements. GI absorption may be decreased in patients with malabsorption syndromes. Therefore, larger dosages may be required when these supplements are given orally. Parenteral administration may be appropriate.