Short characterization of approved iron chelators
| . | DFO . | DFP . | DFX . |
|---|---|---|---|
| Usual dose | 40 mg/kg/d, SC or IV | 75-100 mg/kg/d PO | 14-28 mg/kg/d PO |
| Plasma half-life | 20 min | 1-3 h | 8-16 h |
| Iron excretion | Urine, fecal | Urine | Fecal |
| Cellular permeability | Lowest | Highest | High |
| Cardiac iron removal | Slow | Effective | Effective |
| Advantages | Longest track record | Cardiac iron removal | 24 h Chelation coverage with single dose |
| Disadvantages | Parenteral administration, LPI suppression only during infusion | Frequent WBC monitoring necessary due to possibility of severe neutropenia | Decreased renal plasma flow and GFR |
| Main side effects | Impaired hearing, visual disturbances, nausea, arthralgia, tachycardia, dyspnea | Nausea, vomiting, neutropenia, agranulocytosis, arthropathy, increased transaminases | Decreased renal function, GI intolerance, hepatic impairment, visual and hearing disturbances |
| . | DFO . | DFP . | DFX . |
|---|---|---|---|
| Usual dose | 40 mg/kg/d, SC or IV | 75-100 mg/kg/d PO | 14-28 mg/kg/d PO |
| Plasma half-life | 20 min | 1-3 h | 8-16 h |
| Iron excretion | Urine, fecal | Urine | Fecal |
| Cellular permeability | Lowest | Highest | High |
| Cardiac iron removal | Slow | Effective | Effective |
| Advantages | Longest track record | Cardiac iron removal | 24 h Chelation coverage with single dose |
| Disadvantages | Parenteral administration, LPI suppression only during infusion | Frequent WBC monitoring necessary due to possibility of severe neutropenia | Decreased renal plasma flow and GFR |
| Main side effects | Impaired hearing, visual disturbances, nausea, arthralgia, tachycardia, dyspnea | Nausea, vomiting, neutropenia, agranulocytosis, arthropathy, increased transaminases | Decreased renal function, GI intolerance, hepatic impairment, visual and hearing disturbances |
GI, gastrointestinal; LPI, labile plasma iron; PO, by mouth; SC, subcutaneously.