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• Exjade
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What is Exjade?

Exjade is a substance whose chemical name is Deferasirox, which binds iron and so is used to treat iron overload.

Can it be given to children?

The youngest age that has received this drug is 2 years, using the same starting dose (20mg) as for adults.

Are there any precautions to be considered before taking Exjade?

Before prescribing this treatment your doctor should be informed about any allergies to drugs, kidney conditions, liver disease, visual or hearing problems.

What is the dose?

Usually 20mg/kg/day are given to maintain iron balance in the body but 30mg/kg/day are required to reduce iron overload. In some patients an even higher dose may be needed and trials have shown that a dose of 40mg/kg/day may be used.

How is it taken?

The medication is taken once a day, on an empty stomach, at least 30 minutes before food – preferably the same time each day. Each tablet is dissolved in water, orange juice or apple juice and the mixture is taken right away. Use half a cup if the dose is less than 1000mgs (1g) or a full cup (around 200ml) if the dose is more than 1000mgs. Any residue in the cup after taking the suspension should be resuspended in a small volume of water and swallowed.

How are the tablets stored?

Room temperature (15-30°C) avoiding very warm or moist environments.

What if a dose is missed?

Take it as soon as you remember, unless you remember very near your next scheduled dose, in which case take the medicine at the next scheduled time. Do not take an extra amount to make up for the missed dose.

What are the possible side effects?

Allergy manifesting as a rash (urticaria), swelling of face, lips, tongue or throat and in severe cases difficulty in breathing. Problems in vision and hearing. These are the most severe side effects and must be reported to the doctor promptly. Less serious effects are mild upsets with stomach pain, nausea, vomiting or diarrhoea; fever; skin rash; cough, runny or stuffy nose; headache and sinus pain. Most of these side effects are temporary, at the start of treatment and disappearing in time, without having to stop taking the medicine or reducing the dose.

Does this treatment need monitoring with lab tests?

Renal and liver function tests are monitored monthly during treatment because reactions in both kidneys and liver have been reported, even though these are rarely serious. Caution is especially needed in patients who already have impaired kidney or liver function, in whom it is best not to use this drug. Exjade is interrupted if S. Creatinine continues to rise above the upper limit of normal for age.

Are there interactions with other medicines? Should I avoid taking Exjade while taking other drugs?

At this time Deferasirox has not yet been tested in conjunction with other chelating agents. Combination therapy should be avoided until tests have been carried out by scientists. It is also recommended to avoid taking Exjade along with antacids which contain aluminium (these include Gaviscon, Maalox, Amphigel, Mi-Acid, Mylanta, Rulox and others). Doses of Vitamin C up to 200mg are well tolerated with Derasirox but there have been no formal studies with higher doses.

Can Deferasirox be used in pregnancy and breast feeding?

In animal studies there was no evidence of harm to the embryo. However, it is recommended to stop the drug in pregnancy and when breastfeeding.

 

Last updated: December 2010, by Dr Michael Angastiniotis, MD, DCH (Paediatrician)