Kelfer
Deferiprone (1,2-dimethyl-3-hydroxypyrid-4-one) alias L1
The world's first oral iron chelator
Kelfer (deferiprone) is a iron chelator administered in the form of capsules to patients of thalassaemia major. It is being sold in India since March 1995 commercially.
How does Kelfer act ?
Kelfer acts by combining with the excess iron in the body to form a complex which is excreted in the urine. This over a period of time leads to reduction in the iron overload in the body.
What is the usual dose of Kelfer ?
Studies have found that the optimum dose of Kelfer is 75 mg/kg/day in 2-4 divided doses taken with or without food. In some patients doses upto 100 mg/kg/day may be administered while in others lower doses of 50 mg/kg/day may be sufficient.
What are the side effects of Kelfer ?
In about 20% of patients, joint pains involve knees, hips, elbows or other joints. The pain may be accompanied by swelling in a few cases. This effect is completely reversible on discontinuation of the drug.
In about 12%, Kelfer can reduce white cell counts. This can be dangerous and may predispose the patients to infections. In such situations, the patient may develop fever sore throat etc. The drug should be immediately stopped, the treating physician consulted and appropriate therapy instituted. In some cases, hospitalization may be required till the counts come back to normal.
What are the precautions to be observed while taking Kelfer?
Patients taking Kelfer should be regularly monitored for their blood counts and joint pains. If the total white blood cells falls below 3000/cc of blood or absolute neutrophil counts to below 1500/cc, Kelfer should be immediately discontinued. If the patient develops fever or sore throat, the drug should be discontinued, a blood should be immediately done and if the counts are low (as mentioned above), the physician should be seen immediately.
How is Kelfer available to patients ?
Kelfer is manufactured by Cipla Ltd and is available to patients through Cipla sales offices all over India under certain guidelines. Physicians have to fil up special prescription and patient consent forms prior to initiating therapy with Kelfer. The drug is supplied for a period of 13 months. Subsequently, everytime Kelfer is purchased, a fresh prescription order form has to be filled.
What is the cost of Kelfer therapy ?
For the patients in India the monthly cost of Kelfer therapy works out to Rs.2,000/- on an average with one 250 mg capsule costing Rs.9.75 and one 500 mg capsule costing Rs.16.00
How has Kelfer helped patients of thalassaemia in India ?
The introduction of Kelfer has led to more number of patients taking chelation therapy due to its excellent compliance and low cost. More than 1000 patients have taken Kelfer with good results. Overall, this has led to a better quality of life for thalassaemic patients.
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