Deferasirox (Exjade) is an oral iron chelator. Its main use is to reduce chronic iron overload in patients who are receiving long-term blood transfusions for conditions such as beta-thalassemia and other chronic anaemias.
What is Exjade?
- EXJADE is indicated for the treatment of chronic iron overload due to frequent blood transfusions (≥ 7 ml/kg/month of packed red blood cells) in patients with beta thalassemia major aged 6 years and older.
EXJADE is also indicated for the treatment of chronic iron overload due to blood transfusions when deferoxamine therapy is contraindicated or inadequate in the following patient groups:
- in patients with beta thalassemia major with iron overload due to frequent blood transfusions (≥7 ml/kg/month of packed red blood cells) aged 2 to 5 years
- in patients with beta thalassemia major with iron overload due to infrequent blood transfusions (<7 ml/kg/month of packed red blood cells) aged 2 years and older
- in patients with other anemias aged 2 years and older
EXJADE is also indicated for the treatment of chronic iron overload requiring chelation therapy when deferoxamine therapy is contraindicated or inadequate in patients with non-trans fusion-dependent thalassemia syndromes aged 10 years and older.
What is the dosage?
Titrate and monitor to reach chelation goals
Monitor serum ferritin monthly and assess trends with steady-state levels
- Titrate EXJADE by steps of 5 mg/kg/day to 10 mg/kg/day every 3 to 6 months based on individual patient's response and therapeutic goals (maintenance or reduction of iron)
- EXJADE is approved at doses up to 40 mg/kg/day for patients not adequately controlled with doses of 30 mg/kg (eg, serum ferritin levels persistently above 2,500 µg/L and not showing a decreasing trend over time)
- Doses above 40 mg/kg are not recommended because there is only limited experience with doses above this level
- Dose reductions, in steps of 5 to 10 mg/kg, should be considered in patients whose serum ferritin levels have reached the target (usually between 500 and 1000 µg/L) in order to maintain serum ferritin levels within the target range