Iron Chelation — Oral 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 oral iron-chelating agent used to treat transfusional iron overload, particularly in thalassaemia major, often when 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)

Haematology context (iron chelation in transfusional iron overload / thalassaemia). 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 binds iron and forms a complex that is excreted mainly in the urine, and its small size allows access to intracellular iron pools including the myocardium.

Prescribing in practice

It can cause agranulocytosis and neutropenia, which may be life-threatening, so the neutrophil count must be monitored regularly and the drug stopped immediately if neutropenia or infection develops.
It is generally avoided in pregnancy and in patients with a history of recurrent neutropenia, and concurrent drugs that suppress the marrow should be avoided.
Gastrointestinal upset, arthralgia, raised liver enzymes and reddish-brown discolouration of the urine can occur.

Monitoring

Monitor the full blood count, especially the neutrophil count, at regular intervals throughout treatment, alongside liver function and serum ferritin.

Counselling the patient

Report any sign of infection such as sore throat, fever or feeling generally unwell straight away and have a blood count checked.
Do not miss your scheduled blood tests, as they detect a serious fall in white cells.
Reddish-brown urine is expected and harmless, but report severe joint pain or persistent nausea.

Evidence & guidelines

Deferiprone is recognised for its cardiac iron-removal efficacy and its agranulocytosis risk is the basis of mandatory blood-count monitoring highlighted in MHRA and SPC guidance.

Reference: MHRA Drug Safety Update; UK Thalassaemia Society Guidelines 2022; Pennell et al. Blood 2006; 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).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways