. Author manuscript; available in PMC: 2016 Apr 1.

Published in final edited form as: J Pediatr Hematol Oncol. 2015 Apr;37(3):e162–e169. doi: 10.1097/MPH.0000000000000307

Table III.

Chelators, Chelator Toxicities and Monitoring

CHELATOR AND ROUTE OF ADMINISTRATION	TOXICITIES	MONITORING RECOMMENDATIONS

Deferoxamine	Reduced visual acuity	Annual Eye exam
	Impaired color vision	Annual Hearing exam
Subcutaneous or parenteral infusion	Abnormal visual evoked potentials	Annual zinc level
	Night blindness
	Lens opacities
	High frequency sensorineural hearing loss
	Tinnitus
	Growth retardation
	Genu valgum
	Zinc deficiency

Deferasirox	Gastrointestinal toxicity: nausea, vomiting, diarrhea, abdominal pain	LFTs every 2 weeks, at one month, then monthly
Oral		Renal function and urinalysis monthly
	Increased creatinine	Renal function and urinalysis monthly
	Proteinuria	CBC with differential every 3 months
	Increased ALT	CBC with differential every 3 months
		Consider annual eye exam
		Consider annual hearing exam

Deferiprone	Neutropenia / Agranulocytosis	CBC with differential weekly^*
		Consider annual eye exam
Oral		Consider annual hearing exam

In the US, deferiprone is subject to a Risk Evaluation and Management system (REMS) and limited distribution; both patients and prescribers must sign to the effect that they understand the importance of monitoring weekly CBCs.