Table 2.

Comparison between iron chelators (adapted from [4])

Characteristics	Deferoxamine (Desferal)	Deferiprone (Ferriprox)	Deferasirox (Exjade)
Route of administration	Subcutaneous or intravenous	Oral	Oral
Half-life	20 min	2–3 h	8–16 h
Routes of iron excretion	Urine/stool	Urine	stool
Dose range	20–60 mg/kg per day	50–60 mg/kg per day	20–30 mg/kg/day
Guidelines for monitoring therapy	Audiometry and eye exams annually	Complete blood count weekly; ALT level monthly for first 3–6 months then every 6 months	Serum creatinine level monthly; ALT level monthly
	Serum ferritin	Serum ferritin	Serum ferritin
	Assessment of liver iron annually	Assessment of liver iron annually	Assessment of liver iron annually
	Assessment of cardiac iron annually after 10 years of age	Assessment of cardiac iron annually after 10 years of age	Assessment of cardiac iron annually after 10 years of age
Advantages	Long-term experience	Orally active	Orally active
	Effective in maintaining normal or near-normal iron stores	Safety profile well established	Once-daily administration
	Reversal of cardiac disease with intensive therapy	Enhanced removal of cardiac iron	Demonstrated equivalency to deferoxamine at higher doses
	May be combined with deferiprone	May be combined with deferoxamine	Trials in several hematologic disorders
Disadvantages	Requires parenteral infusion	May not achieve negative iron balance in all patients at 75 mg/kg per day	Limited long-term data
	Ear, eye, bone toxicity	Risk of agranulocytosis	Need to monitor renal function
	Poor compliance		May not achieve negative iron balance in all patients at highest dose