The efficacy of oral deferiprone in acute iron poisoning

Due to its high cost and need for parenteral administration, the standard i ron chelator deferoxamine is not used in many individuals with acute and ch ronic iron poisoning worldwide. Deferiprone is the first oral iron chelator to be shown to be effective in chronically iron overloaded thalassemia pat ients. Its efficacy, by oral administration, in acute iron poisoning has no t been tested. Our objective was to determine whether orally administered d eferiprone can reduce the mortality of rats following acute, toxic, oral do ses of iron. Rats were administered 612 mg/kg elemental iron orally, corres ponding to LD50 in the species tested. Two other groups received the same o ral dose of iron followed by oral deferiprone: 800 mg/kg and 800 mg/kg, fol lowed by another dose of 800 mg/kg 2 hours later. Coadministration of 800 m g/kg deferiprone with the iron decreased mortality from 30% to 6.6% after 2 hours (P = .02), from 40% to 16.6% after 12 hours (P = .04), and from 53.3 % to 20% after 24 hours (P = 0.007), Mortality was also significantly decre ased among animals coadministrated 2 repeated doses of deferiprone of 800 m g/kg with iron, to 0%, 9%, and 18%, and 2, 12, and 24 hours postdrug admini stration, respectively (P = .04, .05, .04, respectively). Histologically, t here was a dose-dependent decrease in iron accumulation in the gastrointest inal tract, Orally administered deferiprone can decrease morbidity and mort ality caused by acute iron overdose in rats. Oral deferiprone holds promise in the treatment of iron poisoning in humans. Copyright (C) 2000 by W.B. S aunders Company.