Uses of Defera: - Iron overload - Transfusion dependent thalassemia Thalassaemia, Iron overload Agranulocytosis, pregnancy and lactation.

Antidote preparations

Deferiprone is a chelating agent with an affinity for ferric ion (iron III). Deferiprone binds with ferric ions to form neutral 3:1 (deferiprone:iron) complexes that are stable over a wide range of pH values. Deferiprone has a lower binding affinity for other metals such as copper, aluminum and zinc than for iron.

How to use Deferiprone: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Deferiprone may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Transfusional Iron Overload Iron chelator indicated for treatment of transfusional iron overload caused by thalassemia syndromes when current chelation therapy is inadequate 25-33 mg/kg PO TID (ie, total daily dosage range 75-99 mg/kg/day) Round dose to nearest 250 mg

Avoid using deferiprone with aluminium-containing antacids as it can chelates trivalent metal ions.

Agranulocytosis, pregnancy and lactation.

Common - Fatigue - Headache - Nausea - Vomiting - Abdominal pain - Joint pain - Diarrhea >10% Chromaturia (14.6%),Nausea (12.6%),Abdominal pain/discomfort (10.4%) 1-10% Arthralgia (9.8%),Vomiting (9.8%),Increased ALT (7.5%),Decreased neutrophil count (7.3%),Neutropenia (6.2%),Increased appetite (4%),Diarrhea (3%),Headache (2.5%),Dyspepsia (2%),Back pain (2%),Extremity pain (1.9%),Increased weight (1.9%),Agranulocytosis (1.7%),Arthropathy (1.4%),Increased AST (1.2%),Decreased appetite (1.1%)

Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Precaution: Hepatic and renal impairment. Neutropenia, monitor neutrophil count wkly and discontinue treatment if neutropenia develops. Limited experience in children 6-10 yr. Lactation: Unknown whether distributed in breast milk; because of the potential for adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Antidote preparations

Deferiprone is an orally effective iron-chelating agent. It is being used when desferrioxamine is unsuitable or contraindicated.

Pregnancy Limited available data with use in pregnant women are insufficient to inform a drug-associated risk of major birth defects and miscarriage Verify the pregnancy status of females of reproductive potential prior to initiating therapy Contraception Females: Advise females of reproductive potential to avoid pregnancy during treatment and 6 months of contraception is recommended after cessation of therapy; advise females to immediately report pregnancy Males: Advise males with female sexual partners of reproductive potential to use effective contraception during treatment and 3 months of contraception is recommended after cessation of therapy Lactation There is no information regarding the presence of deferiprone in human milk, the effects on the breastfed child, or the effects on milk production Because of the potential for serious adverse reactions, including the potential for tumorigenicity shown for deferiprone in animal studies, advise not to breastfeed during treatment and for 2 weeks after last dose