What is Kelfer?
Kelfer (deferiprone) is an iron chelator administered in the form of capsules to the patients of thalassaemia major.
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 of the body.
What is the usual dose of Kelfer?
Studies have found that the optimum dose of Kelfer is 75mg/kg/day in 2-4 divided doses taken with or without food.
In some patients doses up to 100mg/kg/day may be administered while in others lower doses of 50mg/kg/day may be sufficient.
What are the side effects of Kelfer?
In about 20 percent 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 percent patients, Kelfer can reduce white cell counts in blood. 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, hospitalisation may be required till the counts come back to normal.
Some patients experience vomiting tendency which is usually temporary and decreased after 10-15 days of therapy. It is recommended to start drug from a low dose then build up to standard dose over 2-4 weeks time. Anti-emetic drugs also help.
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 test should be immediately done and if the counts are low (as mentioned above), a physician should be immediately consulted.
Is Kelfer Safe?
Kelfer is a safe and effective drug if the side effects are explained to the patients and the above precautions are undertaken to monitor complications.
Is Kelfer better for heart, what is combination therapy?
Iron induced heart disease is the major cause of death among thalassemia patients.
A study published in the Journal Haematologica, reveals that long-term therapy with deferiprone (Kelfer) provides greater protection of the heart from iron overload than standard therapy (Desferal).
The study of combination therapy showed that the favorable effects of both deferiprone (Kelfer) and deferoxamine (Desferal) can be utilised in patients with iron overload by addressing cardiac iron (deferiprone) and hepatic iron (deferoxamine).
Thus combination therapy has a dual action increasing total iron excretion from the body.
How is Kelfer available to patients in Bangladesh?
Kelfer is available to the thalassaemia patients in this country through Bangladesh Thalassemia Foundation (BTF) [House # 36, Road # 27, Dhanmondi, Dhaka 1209; Phone: 01915538339, 01915458065] under certain guidelines.
The patient must be registered to the Foundation with an initial fee and 2 copy photograph. The treating physicians have to fill up special prescription and patient consent forms prior to initiating therapy with Kelfer.
The drug is supplied for a period of 1 month at a time. Subsequently, every time Kelfer is purchased, a fresh prescription order form has to be filled.