Ferriprox absorption on transfusion day.

Andy,

I would like to open a new topic and ask yours and everyone else's opinion about that:
baal told me while discussing about ferriprox in the chat room, that doctors in Germany do not suggest intake of ferriprox on the transfusion day. The reason is that blood strengthens  intestine and stomach, making ferriprox difficult to be absorbed. That is why not only they do not take ferriprox on the transfusion day but also the doctors tell them they can eat food rich in iron that same day, because iron cannot be absorbed as well.

I have not heard that. Have you?
Panos said that dr. Tondury suggests that.

If anyone has heard something relevant, pls info.
Thanks.

Lena.

Lena,

I will check with ApoPharma about this.

Thank you Andy, prompt as always.
And keep on with the good work with this site. I'll certainly do my best to spread the word.

Lena.

I contacted Gerry at ApoPharma and he reported this.

I spoke with Fernando Tricta who is VP Medical Affairs. He is not aware of this practice and we have  no  data for or against it

I really question depriving patients of chelation on the day of transfusion, because this is when the patient needs chelation the most to remove free iron in the blood. I would not advise skipping chelation on transfusion day, unless we can get some scientific evidence to back up that claim.

You are quite right,Andy.Today I asked my doctors about it and they questioned it as well. It is not logic at all. Thanks again for your prompt reply.

I would have thought that with the extra iron from the transfusion, chelation would be very important. 
I can only stick to what I know and that is chelate whether I'm being transfused or not.

Well,
my Thal center stoped Patients to have chelation during Tx , the reason they gave when i asked was , it would be difficult to figure out to wat infection/reaction took place if you're having both (Desferal and Blood ) infusion at same time , but i argue, that i never had any reaction from Desferal soo let me have chelation , but they were stubborn but after that i discussed to thal center's doctor that i have to take  IV Desferal so allow me  .. and then she prescripted on my file and never argued again ..  they said desferal is 33% effective with blood and i said its better than nothing ... and i got permission ... now as usual i m having Desferal during chelation , and also Ferriprox tabs bfore going to center and offcourse Vit-E ... 

Best Regards
Take Care
Umair

Not sure about L1 or Exjade, but hematologists in US have now started recommending against taking Desferal with blood transfusions. I have been getting desferal on and off with transfusions. Since about 2 years, however, I have been stopped IV desferal with the blood transfusions. I believe the reason for doing so is more than just the affectiveness of the drug. It has to do with developing reactions and not knowing exactly whether the patient is reacting to blood or desferal.
I also vaguely remember my doc telling me about recent research showing some harm to cardiac muscle (perhaps absorbing more iron)  or to something else when desferal is infused alongside transfusion.

Like I said, I'm not sure about the 2nd reason I pointed out above. Perhaps other fellows who have been advised against taking desferal while being transfused can share why so? Perhaps Andy could also share his knowledge on this topic?

Regards,
SF

hello.
My doctor also told me not to take desferal while bt,
i asked the reason but i could n't get it

For Complete Article, please visit :
http://www.drugs.com/mmx/deferoxamine-mesylate.html
Revised: 06/22/2000

For chronic iron overload
The route of administration, either intramuscular or subcutaneous, must be individualized for each patient.

Because of the short serum half-life of deferoxamine, most of the drug may be rapidly excreted after a single intramuscular injection without binding any iron. However, continuous subcutaneous infusion may be almost as effective in mobilizing iron as continuous intravenous infusion. {19} Therefore, a small mechanical infusion pump may be used to administer deferoxamine into the subcutaneous tissue of the abdomen. Deferoxamine is then infused very slowly over 8 to 16 hours on an outpatient basis. {13} The duration of subcutaneous infusion with a portable mini-infusion pump must be individualized, depending on the rate of the patient's iron excretion. This regimen may remove 2 to 3 times more iron than a single daily intramuscular injection. {13}

Patients who do not tolerate deferoxamine therapy because of cutaneous pain and swelling or hives may receive the medication via an infusion pump in an indwelling central venous line at an adult dose of 2 to 4 grams (40 to 80 mg/kg of body weight) administered over 12 to 16 hours.

If a net negative iron balance in response to deferoxamine can be achieved, long-term therapy should be considered in patients with transfusional iron overload.

[bgcolor=#ffffff]If blood is transfused during deferoxamine therapy, it must not be mixed in the same container with deferoxamine.[/bgcolor]
Iron toxicity, chronic
Intramuscular, 500 mg to 1 gram a day.

Intravenous, [bgcolor=#ffffff]in addition to intramuscular administration, 2 grams infused at a rate not to exceed 15 mg per kg of body weight per hour. This is administered at the same time each unit of blood is transfused, but through a separate line.[/bgcolor]

Subcutaneous, 1 to 2 grams (20 to 40 mg per kg of body weight) a day administered over a period of eight to twenty-four hours by means of a portable, continuous mini-infusion pump

this study Revised on : 06/22/2000  ... old study but its the only research i found on internet about not  using desferal in same line ..... no details provided about the reason of this advise to not having desferal in the same line with blood ...

Best Regards
Take Care
Umairrrrr

Considering my blood is going through port and chelation is subcut, There is no cross mixing.
Probably why my haematologist isn't concerned and again its my choice whether I want to subcut or wait til after transfusion to use my port.
For me, I think it is what helps me to try and get the ferritin down without causing too many issues and problems.