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(de-fer-ip-rone) ,


(trade name)


Therapeutic: antidotes
Pharmacologic: chelating agents
Pregnancy Category: D


Treatment of transfusional iron overload due to thalassemia when other chelation regimens are inadequate.


Bonds with ferric ions to form neutral complexes which are then eliminated.

Therapeutic effects

Decrease in iron overload as reflected in decreased ferritin levels.


Absorption: Well absorbed following oral administration.
Distribution: Unk.
Metabolism and Excretion: Mostly metabolized (by UGT 1A6 enzyme system), 75–90% excreted in urine as metabolites.
Half-life: 1.9 hr.

Time/action profile (blood levels)

POwithin 5–10 min1–2 hr8–12 hr


Contraindicated in: Hypersensitivity; Obstetric: Pregnancy should be avoided; Lactation: Breast feeding not recommended.
Use Cautiously in: Renal/hepatic impairment (safety and effectiveness not established); Any risk/history of QT prolongation including HF, bradycardia, diuretic use, cardiac hypertrophy, hypokalemia, hypomagnesemia; Pediatric: Safe and effective use in children has not been established.

Adverse Reactions/Side Effects

Central nervous system

  • headache


  • Torsades de Pointes (life-threatening)


  • abdominal pain (most frequent)
  • nausea (most frequent)
  • change in appetite
  • vomiting
  • ↑ liver enzymes


  • chromaturia (most frequent)


  • agranulocytosis (life-threatening)
  • neutropenia


  • arthralgia
  • arthropathy
  • back pain
  • extremity pain


  • ↓ zinc levels


Drug-Drug interaction

Concurrent use of other drugs that cause neutropenia/agranulocytosis may ↑ risk of neutropenia/agranulocytosis. May also chelate other concurrently administered polyvalent cations in mineral supplements and antacids, including iron, aluminum and zinc ; wait 4 hr between administration.


Oral (Adults) 25 mg/kg three times daily, may be adjusted up to 33 mg/kg three times daily (range 75–99 mg/kg/day in divided doses). Dose should be rounded to the nearest 250 mg (1/2 tablet).


Tablets: 500 mg

Nursing implications

Nursing assessment

  • .
  • Lab Test Considerations: Monitor serum ferritin every 2–3 mo to assess efficacy. If serum ferritin falls consistently below 500 mcg/L, consider temporarily interripting deferiprone therapy.
    • Measure ANC before starting and weekly during therapy. Interrupt deferiprone if neutropenia (ANC <1.5 X 109/L) or if infection develops. If ANC <1.5 X 109/L and >0.5 X 109/L, obtain CBC with WBC corrected for presence of nucleated red blood cells, ANC, and platelet count daily until recovery (ANC ≥1.5 X 109/L. For agranulocytosis (ANC <0.5 X 109/L), Consider hospitalization and manage as clinically appropriate. Do not resume deferiprone in patients who develop agranulocytosis or rechallenge patients who develop neutropenia, unless benefits outweigh risks.
    • Monitor serum AST and ALT monthly during therapy. Interrupt therapy if persistent ↑ in serum transaminases occurs.
    • Monitor plasma zinc levels. ↓ may occur and may require supplementation.

Potential Nursing Diagnoses

Risk for infection (Adverse Reactions)


  • Oral: Administer first dose in the morning, second dose midday, and third dose in the evening. May be taken with meals to decrease nausea.

Patient/Family Teaching

  • Instruct patient to take deferiprone 3 times/day. Take missed doses as soon as remembered, but not just before next dose. Do not double doses.
  • Advise patient to stop therapy and notify health care professional immediately if signs and symptoms of infection (fever, sore throat) or if palpitations, dizziness, syncope, or seizures occur.
  • Inform patient that reddish/brown urine may occur; common and not harmful.
  • Advise female patients to use contraception and avoid breastfeeding during therapy. If pregnancy is planned or suspected, notify health care professional promptly.

Evaluation/Desired Outcomes

  • Decrease in serum ferritin levels.
References in periodicals archive ?
para]]This Global Report 2015 is a result of industry experts' diligent work on researching the world market of deferiprone.
The iron chelators available are deferoxamine (given parenterally), deferiprone and deferasirox (given orally).
For example, idebenone and deferiprone have been shown to improve cardiac and neurologic function in symptomatic patients (17-19).
Reversal of cardiac complications by deferiprone and deferoxamine combination therapy in a patient affected by a severe type of juvenile haemochromatosis (JH).
When some of the rabbits were treated with the iron-chelating agent deferiprone, plasma cholesterol and iron levels were lowered, and even though brain iron levels were not also reduced, amyloid beta and phosphorylated tau were significantly decreased.
Following treatment with a drug called deferiprone (an iron chelator), the iron level in the rabbits' blood plasma was reduced and the levels of both beta-amyloid and phosphorylated tau in the brain were returned to normal levels.
Desferal administrated two to three times per week achieves iron excretion greater than induced by daily deferiprone [9]
Nancy Olivieri had safety concerns about deferiprone, the drug she was testing for Apotex.
Deferasirox and deferiprone are two orally-active iron chelators that have been approved for clinical use, but they are not yet easily accessible to all patients [2].
Reduction of copper and metallothionein in toxic milk mice by tetrathiomolybdate, but not deferiprone.
Combined therapy with desferrioxamine and deferiprone in beta thalassemia major patients with transfusional iron overload.
ATLANTA -- Intensive combination chelation therapy with desferrioxamine and deferiprone dramatically improved survival and led to reversal of secondary iron overload toxicity in this study of 50 [beta]-thalassemia major patients aged 8-48 years, according to Greek researchers.