Table 3 Comparative analysis of different iron chelators
From: Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area
| Â | Deferoxamine (DFO) | Deferiprone (DFP) | Deferasirox (DFX) |
|---|---|---|---|
Brand name | Desferal | Ferriprox | Exjade |
Chelator- iron, complex ratio | Hexadentate, 1:1 | Bidentate, 3:1 | Tridentate, 2:1 |
Dose (mg/ kg/ day) | 25–50 | 75–100 | 20–40 |
Combination and titration doses (mg/ kg/ day) | Combination therapy with DFO and DFP, 2 days/week DFO and then continue with DFP | Titration therapy | |
Administration | Subcutaneous or intravenous, 8–10 hrs/day, 5–7 days/wk | Oral, 3 times daily | Oral, once daily |
Plasma half-life (hr) | 0.5 | 2–3 | 8–16 |
Route of elimination | Biliary and urinary | Urinary | Biliary |
Regulatory approval | US, Canada, Europe, other countries | US, Europe, other countries | US, Canada, Europe, other countries |
Indication | Transfusion iron overload and acute iron overload | Transfusion iron overload when DFO is contraindicated or inadequate | Transfusion iron overload |
Adverse events | Irritation at the infusion site, ocular and auditory disturbances, growth retardation and skeletal changes, allergy, respiratory distress syndrome with higher doses | Agranulocytosis and neutropenia, gastrointestinal disturbances, arthropathy, increased liver enzyme levels, low plasma zinc level, hepatic fibrosis | Gastrointestinal disturbances, rash, increase in serum creatinine level; potentially fatal renal impairment or failure |
Advantage/ Disadvantage | Inexpensive/ Compliance | Route of administration / Compliance | Route of administration / Expensive |