What are the available iron chelators?

By William Aird

  • Deferoxamine (parenterally administered)
  • Deferasirox (orally administered)
  • Deferiprone (orally administered)

Comparison table

ParameterDeferoxamine Deferasirox Deferiprone
Route of administrationIV, SCOralOral
Typical dose30-60 mg/kg/day 5-7 days/week over 8-12 hours/day20-40 mg/kg once daily for dispersible tablet; 14-28 mg/kg/day for film-coated tablet or granules75 mg/kg/day in 3 divided doses (up to 99 mg/kg/day)
Half-life20 minutes8-16 hours (allows once daily dosing)1-3 hours
Major side effectsInfusion reactions, auditory and ophthalmologic effects, hypersensitivity reactions Gastrointestinal symptoms, skin rash, transaminitis, renal dysfunctionGastrointestinal symptoms, transaminitis, neutropenia, arthropathy
ProsAvailable since 1970s, therefore well studied, only chelating drug acceptable in pregnancyOral administration, once dailyOral administration
ConsInconvenience of parenteral administration, poor complianceCost3 divided doses (vs. once daily for deferasirox), weekly blood monitoring
IV, intravenous; SC, subcutaneous