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Oral iron chelator Pregnancy: Contraindicated in pregnancy and breast-feeding. Genotoxic potential; women of childbearing potential should use effective contraception and avoid pregnancy during treatment and for 6 months after; men for 3 months after. Pregnant women must stop taking deferiprone immediately.

Deferiprone

Brand names: Ferriprox

Deferiprone is an orally administered iron-chelating agent used for transfusional iron overload, often in thalassaemia, particularly where other chelators are inadequate or contraindicated.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 25 mg/kg body weight three times daily (total 75 mg/kg/day)
Route: Oral
Frequency: Three times a day
Max: A total daily dose above 100 mg/kg/day is not recommended (increased risk of adverse reactions)
Usually 25 mg/kg three times daily for a total daily dose of 75 mg/kg. Therapy initiated and maintained by a physician experienced in treating thalassaemia. Dose per kg calculated to the nearest half tablet. Monitor serum ferritin (or other body-iron indicators) every 2-3 months; adjust to the individual patient's response. Consider interrupting therapy if serum ferritin falls below 500 microg/l. When used with deferoxamine (inadequate monotherapy): 75 mg/kg/day, not exceeding 100 mg/kg/day; for iron-induced heart failure add deferiprone 75-100 mg/kg/day to deferoxamine. Paediatric: limited data in children aged 6-10 years; no data below 6 years of age.

Dose adjustments

Renal

No dose adjustment required in mild, moderate or severe renal impairment; safety/pharmacokinetics in end-stage renal disease are unknown.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients
  • History of recurrent episodes of neutropenia
  • History of agranulocytosis
  • Pregnancy
  • Breast-feeding

Side effects

  • Neutropenia and agranulocytosis (agranulocytosis approx. 1% of patients; less severe neutropenia approx. 5%)
  • Nausea, vomiting, abdominal pain, diarrhoea (nausea/vomiting/abdominal pain very common)
  • Chromaturia (reddish-brown urine) - very common
  • Headache; increased appetite
  • Rash, urticaria; arthralgia; increased liver enzymes; fatigue

Interactions

  • Must not be taken with medicinal products known to be associated with neutropenia or that can cause agranulocytosis

Clinical monograph

How it works

It is a bidentate chelator that binds iron and promotes its urinary excretion, and it can access iron in tissues such as the myocardium.

Prescribing in practice

  • Can cause agranulocytosis and neutropenia, which may be life-threatening, so the neutrophil count must be monitored and treatment interrupted if neutropenia develops.
  • Patients must be told to report any signs of infection such as fever or sore throat immediately so blood counts can be checked.
  • Use with caution alongside other medicines that may cause neutropenia or agranulocytosis.

Monitoring

Monitor the full blood count, especially the neutrophil count, regularly throughout treatment, together with serum ferritin and liver function.

Counselling the patient

  • Seek urgent medical advice and a blood count if you develop fever, sore throat or other signs of infection.
  • The medicine may cause a reddish-brown discolouration of the urine, which is harmless.

Evidence & guidelines

The risk of agranulocytosis with deferiprone is well established and reflected in MHRA and product safety guidance.

Reference: BSH iron overload; NICE TA161; MHRA Drug Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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