Ferriprox/Desferal and Calcium Interactions

Hi Andy (and everyone else ),

I am currently taking 1500mg Ferriprox three times daily and 2.5mg/16ml desferal subcutaneous over 8 hours daily. I am also trying to fit in calcium+vit D supplements. Currently, I'm taking the calcium at the same time as the Ferriprox and desferal (when I start the infusion). I was wondering if it was okay to take calcium+Vit D with the iron chelators.

When I checked Drugs.com interaction checker, I get:
Applies to: Calcium 600 D (calcium / vitamin d), Ferriprox (deferiprone)
ADJUST DOSING INTERVAL: Deferiprone has the potential to bind polyvalent cations such as aluminum, iron and zinc, which may reduce its effectiveness. However, concurrent use with foods, mineral supplements, or antacids that contain polyvalent cations has not been studied.
MANAGEMENT: A minimum 4-hour interval is recommended between the administration of deferiprone and mineral supplements or oral medications that contain antacids (e.g., didanosine buffered tablets or pediatric oral solution) or other polyvalent cations.

To me, this seems very ambiquous; It could bind and lower efficiency of the iron chelators but it hasn't really been studied is what I get out of it. The Ferriprox pharmacist says that it should be fine to take together, that there are no interactions. I guess I'm just confused on which to follow, the pharmacist or the research online.

Anyone have any input? How are you guys taking your iron chelators and calcium? Do you guys take it together at the same time, or do you stagger it and take it at separate times? If you guys separate them, how far apart?

Thanks,
Archana

All iron chelators also will remove other minerals, so it's important to supplement, as you are doing. The reason why taking minerals at the same time as the chelator, is not that it will cause a loss of minerals, but it may somewhat dilute the effect of the chelator if it is able to react with minerals in your stomach. I don't think this could be a big problem though, as the chelators do not react the same as they do with iron and it would seem any neutralization of the chelator would be minimal. If iron chelators chelated calcium at the same rate as iron, they would not be of any use.