is a component [10%:<1,500/mm 3 and> 500/mm 3 : Interrupt treatment immediately and monitor until recovery; do not rechallenge unless the potential benefit outweighs the risk. ANC <500/mm 3 : In addition to treatment interruption, consider hospitalization (and other clinically-appropriate management); do not resume unless the potential benefits outweigh potential risks Infection: Interrupt treatment; monitor ANC more frequently Administration Administer in the morning, at midday and in the evening. Administration with food may decrease nausea. Administer after at least a 4-hour interval with medications or supplements containing polyvalent cations (iron, aluminum, zinc). Dietary Considerations May be taken with food to decrease nausea. Allow at least a 4-hour interval with foods containing iron, aluminum, and zinc. Storage Store at 20 C to 25 C (68 F to 77 F); excursions permitted to 15 C to 30 C (59 F to 86 F). Store oral solution in original carton to protect from light; use contents within 35 days after first opening bottle; discard any remaining solution after 35 days. Drug Interactions Antacids: May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Exceptions: Sodium Bicarbonate. Consider therapy modification Calcium Salts: May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification Iron Salts: May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Exceptions: Ferric Carboxymaltose; Ferric Gluconate; Ferric Hydroxide Polymaltose Complex; Ferric Pyrophosphate Citrate; Ferumoxytol; Iron Dextran Complex; Iron Isomaltoside; Iron Sucrose. Consider therapy modification Magnesium Salts: May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification Multivitamins/Minerals (with ADEK, Folate, Iron): May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification Multivitamins/Minerals (with AE, No Iron): May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Consider therapy modification Myelosuppressive Agents: May enhance the neutropenic effect of Deferiprone. Avoid combination UGT1A6 Inhibitors: May increase the serum concentration of Deferiprone. Monitor therapy Zinc Salts: May decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Exceptions: Zinc Chloride. Consider therapy modification Adverse Reactions> 10%: Gastrointestinal: Nausea (13%) Genitourinary: Urine discoloration (15%) 1% to 10%: Central nervous system: Headache (3%) Gastrointestinal: Vomiting (10%), abdominal distress ( 10%), abdominal pain ( 10%), increased appetite (4%), diarrhea (3%), dyspepsia (2%), weight gain (2%), decreased appetite (1%) Hematologic & oncologic: Neutropenia (6% to 7%), agranulocytosis (2%) Hepatic: Increased serum ALT (8%), increased serum AST (1%) Neuromuscular and skeletal: Arthralgia (10%), back pain (2%), limb pain (2%), arthropathy (1%) <1% (Limited to important or life-threatening): Abnormal gait, acute respiratory distress, anaphylactic shock, atrial fibrillation, bruxism, cardiac failure, cerebellar syndrome, cerebral hemorrhage, chills, connective tissue disease (chondropathy), cryptococcosis (cutaneous infection), decreased serum zinc, dehydration, depression, diaphoresis, diplopia, drowsiness, encephalitis (enteroviral), enterocolitis, epistaxis, fever, furuncle, gastric ulcer, glycosuria, hemoglobinuria, hemoptysis, hepatitis A, hepatomegaly, hypersensitivity reaction, hypertension, hypospadias, hypotension, IgA vasculitis, increased creatine phosphokinase, increased intracranial pressure, increased serum bilirubin, jaundice, metabolic acidosis, motor dysfunction (pyramidal tract syndrome), multi-organ failure, myositis, obsessive compulsive disorder, pancreatitis, pancytopenia, papilledema, parotid gland enlargement, periorbital edema, peripheral edema, pharyngitis, pneumonia, pruritus, psychomotor disturbance, pulmonary embolism, pustular rash, rectal hemorrhage, retinal toxicity, seizure, sepsis, skin photosensitivity, skin rash, subcutaneous abscess, thrombocythemia, torsades de pointes, trismus, urticaria ALERT: U.S. Boxed Warning Agranulocytosis/Neutropenia: Deferiprone can cause agranulocytosis that can lead to serious infections and death. Neutropenia may precede the development of agranulocytosis. Measure the absolute neutrophil count (ANC) before starting deferiprone therapy and monitor the ANC weekly during therapy. Interrupt deferiprone therapy if neutropenia develops. If infection develops, interrupt deferiprone and monitor the ANC more frequently. Advise patients taking deferiprone to report immediately any symptoms indicative of infection. Warnings/Precautions Concerns related to adverse effects: Agranulocytosis//Neutropenia: [US Boxed Warning]: May cause agranulocytosis, which could lead to serious infections (some fatal). Agranulocytosis may be preceded by neutropenia; monitor absolute neutrophil count (ANC) prior to treatment initiation and weekly during therapy. If infection develops, interrupt treatment and monitor ANC more frequently. Patients should promptly report any symptoms which may indicate infection. Interrupt treatment if neutropenia (ANC> <1,500/mm 3 ) develops; withhold any other medications which may also be associated with neutropenia; monitor CBC, corrected WBC, ANC, and platelets daily until ANC recovery. If ANC> <500/mm 3 , consider hospitalization (and other clinically appropriate management); do not resume or rechallenge unless the potential benefits outweigh potential risks. Neutropenia and agranulocytosis were generally reversible upon discontinuation. The mechanism for deferiprone-induced agranulocytosis is not known. Avoid concurrent use with other agents associated with neutropenia (or agranulocytosis). Hepatotoxicity: Elevations in ALT values have been observed; monitor ALT and consider treatment interruption for persistent elevations. Hypersensitivity: Hypersensitivity reactions have been reported (eg, Henoch-Schönlein purpura [immunoglobulin A vasculitis], urticaria, and periorbital edema with skin rash). Zinc deficiency: Lower plasma zinc concentrations have been observed; monitor zinc levels and supplement if necessary. Monitoring Parameters Serum ferritin (every 2-3 months); ANC (at baseline and weekly during treatment); if ANC> <1,500/mm 3 , monitor CBC, WBC (corrected for nucleated RBCs), ANC, and platelets daily until ANC recovery; ALT (monthly); zinc levels; signs or symptoms of infection Pregnancy Risk Factor D Pregnancy Considerations Adverse effects have been observed in animal reproduction studies. Although there is limited data in humans, deferiprone may cause fetal harm if administered during pregnancy. During treatment with deferiprone in women of reproductive potential, pregnancy should be avoided. Patient Education Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?) Patient may experience joint pain, abdominal pain, nausea, vomiting, or urine discoloration. Have patient report immediately to prescriber signs of infection (HCAHPS). Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients. Next Interactions Print this page Add to My Med List More about deferiprone Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: antidotes Consumer resources Deferiprone ... +3 more Professional resources Deferiprone (AHFS Monograph) Other brands: Ferriprox Related treatment guides Hemosiderosis Iron Overload Superficial Siderosis Thalassemia> ]} Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Deferiprone Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Drug Class Antidotes Chelating agents Related Drugs antidotes naltrexone , atropine , naloxone , acetylcysteine , leucovorin chelating agents Jadenu , Exjade , deferasirox , deferoxamine , trientine , Desferal Thalassemia Jadenu , Exjade , deferasirox , Ferriprox , More... Iron Overload Jadenu , Exjade , deferasirox , Ferriprox , More...} } anybody
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