Iron chelation agents currently available for clinical use; properties and indications.
| Property . | Deferoxamine . | Deferiprone . | Deferasirox . |
|---|---|---|---|
| *Monitoring as per product monograph for all agents | |||
| †Yearly monitoring recommended for all | |||
| ‡Usually reversible or non-progressive | |||
| BTM indicates beta-thalassemia major; DFO, deferoxamine; GI, gastrointestinal; h, hours; IOL, iron overload; iv, intravenous; min, minutes; po, orally; RBC, red blood cell; rxn, reaction; sc, subcutaneous; TD, transfusion-dependent. | |||
| Usual dose | 20–60 mg/kg/d | 75–100 mg/kg/d | 20–30 mg/kg/d |
| Route | sc, iv ≥ 8–12 h, ≥ 5 d/wk | po 3 times daily | po once daily |
| Half-life | 20–30 min | 3–4 h | 8–16 h |
| Excretion | Urinary, fecal | Urinary | Fecal |
| Side effects* | Injection site rxn Potential ocular† and/or otic toxicity† | (rare) agranulocytosis | Renal insufficiency in up to one third‡ GI disturbance |
| Indications | Acute iron intoxication Chronic IOL from TD-anemias | IOL in BTM when DFO contraindicated or inadequate | BTM ≥ 6 y with IOL from frequent RBC transfusion IOL when DFO contraindicated or inadequate in: Other anemias Age 2–5 y BTM with IOL from infrequent RBC transfusion |
| Property . | Deferoxamine . | Deferiprone . | Deferasirox . |
|---|---|---|---|
| *Monitoring as per product monograph for all agents | |||
| †Yearly monitoring recommended for all | |||
| ‡Usually reversible or non-progressive | |||
| BTM indicates beta-thalassemia major; DFO, deferoxamine; GI, gastrointestinal; h, hours; IOL, iron overload; iv, intravenous; min, minutes; po, orally; RBC, red blood cell; rxn, reaction; sc, subcutaneous; TD, transfusion-dependent. | |||
| Usual dose | 20–60 mg/kg/d | 75–100 mg/kg/d | 20–30 mg/kg/d |
| Route | sc, iv ≥ 8–12 h, ≥ 5 d/wk | po 3 times daily | po once daily |
| Half-life | 20–30 min | 3–4 h | 8–16 h |
| Excretion | Urinary, fecal | Urinary | Fecal |
| Side effects* | Injection site rxn Potential ocular† and/or otic toxicity† | (rare) agranulocytosis | Renal insufficiency in up to one third‡ GI disturbance |
| Indications | Acute iron intoxication Chronic IOL from TD-anemias | IOL in BTM when DFO contraindicated or inadequate | BTM ≥ 6 y with IOL from frequent RBC transfusion IOL when DFO contraindicated or inadequate in: Other anemias Age 2–5 y BTM with IOL from infrequent RBC transfusion |