Table 3.

Properties of iron chelators

Property	Deferoxamine	Deferasirox	Deferiprone
Stoichiometry (chelator: iron)	Hexadentate (1:1)	Tridentate (2:1)	Bidentate (3:1)
Usual dose	25–60 mg/kg/day over 8–24 hours	20–40 mg/kg/day once daily	75–100 mg/kg/day in three divided doses
Route of administration	Subcutaneous, intravenous	Orally dispersible tablet	Oral tablet or suspension
Half-life	20–30 minutes	7–16 hours	1.5–2.5 hours
Excretion	Urinary, fecal	Fecal	Urinary
Ability to remove liver iron	+++	+++	++*
Ability to remove cardiac iron	++#	++**	+++
Typical adverse events	Local reactions	Gastrointestinal	Gastrointestinal
	Sensorineural hearing loss	Rash	Neutropenia/Agranulocytosis
	Ophthalmic changes	Rise in creatinine	Arthralgia
	Allergic reactions	Proteinuria	Elevated hepatic enzymes
	Bone abnormalities	Elevated hepatic enzymes
	Increased risk of Yersinia and Klebsiella infections	Gastrointestinal bleeding (rare)
		Fulminant hepatic failure (rare)
	Pulmonary at high doses	Renal insufficiency (rare)
	Neurological at high doses
Availability	Licensed	Licensed	Licensed in Europe and Asia as second-line agent; not licensed in North America

Notes:

^*Reports of insufficient liver iron removal in some patients at doses of 75 mg/kg/day, but higher dosing, especially for subjects with high transfusional iron burden may be more effective;

^#with continuous infusion;

^**data are limited regarding efficacy with very low cardiac T2* and in heart failure; cardiac iron removal also may be less effective in patients with high liver iron concentration.