Deferiprone
Chelating agents
Chelating agentsPregnancy: avoid
Avoid: animal studies showed embryo-fetal death and malformations; effective contraception is used during treatment and for months afterwards.
An oral iron chelator for transfusional iron overload in thalassaemia. Its key danger is agranulocytosis, so blood counts are checked often.
Quick facts
- Group
- Chelating agents
- Target
- Ferric iron (Fe3+)
- Used for
- Transfusional iron overload
- Key effects
- Reddish-brown urine · Nausea · Joint pain
- Monitor
- ALT monthly · Plasma zinc
- ATC
- V03AC02
No doses: the clinician sets them by the current guideline.
Mechanism of action
Deferiprone has a strong affinity for ferric iron: three molecules surround one iron ion and form a neutral complex. The complex is excreted in urine, which can turn reddish-brown. Deferiprone itself is inactivated by glucuronidation (UGT1A6) in the liver into a metabolite that no longer binds iron.
- Transfusions build up iron in tissues
- Three deferiprone molecules bind one ferric ion
- The neutral complex is excreted in urine
- Urine may turn reddish-brown, which is harmless
Indications
- Transfusional iron overload in thalassaemia syndromes when current chelation is inadequate Thalassemias (α and β) →
Adverse effects
Common
- Reddish-brown urine (chromaturia)
- Nausea, vomiting and abdominal pain
- Joint pain
- Raised liver enzymes (ALT)
Contraindications
- Hypersensitivity to deferiprone or its excipients
Key interactions
- UGT1A6 inhibitors (for example diclofenac, probenecid, silymarin)
- Avoided: they slow its inactivation
- Iron, aluminium and zinc products, including antacids and supplements
- Bind deferiprone; doses are separated by several hours
- Other drugs that can cause neutropenia
- Avoided, or neutrophil counts are followed closely
What is monitored
- Absolute neutrophil count before starting, then weekly during the first months and less often later
- ALT monthly
- Plasma zinc
- Serum ferritin every few months
Administration and safety
- Given by mouth; separated from mineral supplements and antacids
- Stopped at once if neutropenia or an infection appears, until reviewed
Pregnancy and breastfeeding
Avoid: animal studies showed embryo-fetal death and malformations; effective contraception is used during treatment and for months afterwards.
Nursing care
- Check the neutrophil count result before each supply
- Teach the patient to report fever, sore throat or mouth ulcers immediately
- Explain that reddish-brown urine is expected
- Ask about joint pain and gastrointestinal upset
Pharmacokinetics
- Metabolism
- Glucuronidated by UGT1A6 to an inactive metabolite
- Elimination
- Mostly in urine, as the metabolite
- Half-life
- About 2 hours
Test yourself
Think of the answer, then tap the question to see it.
What is the boxed warning for deferiprone?
Agranulocytosis and neutropenia, which can lead to serious infection and death.
Why does urine turn reddish-brown during deferiprone treatment?
The iron complex is excreted in urine; it is harmless.
Which enzyme inactivates deferiprone?
UGT1A6, which glucuronidates it to a metabolite that no longer binds iron.
Connections
← Back to the class: Chelating agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - DEFERIPRONE tablet, coated (DailyMed (U.S. National Library of Medicine), 2026); eEML - Electronic Essential Medicines List (World Health Organization, 2025); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.