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deferasirox (Exjade)
oral iron-chelation therapy
Indications:
- iron overload
Dosage: once a day, oral (on empty stomach)
Monitor:
- serum ALT, serum AST, & serum bilirubin (plus serum alkaline phosphatase [Canada]) at baseline, every 2 weeks for the 1st month, then monthly [5]
Adverse effects:
1) acute renal failure, potentially fatal [2,4]
2) cytopenias, including agranulocytosis, neutropenia, thrombocytopenia, potentially fatal [2]
3) leukocytoclastic vasculitis, urticaria
4) hypersensitivity reactions, including anaphylaxis, angioedema [2]
5) liver impairment, including liver failure [4]
6) gastrointestinal hemorrhage [4]
5) greater number of adverse effects in patients > 60 years of age with myelodysplastic syndrome [3]
Drug interactions:
- aluminum-containing antacids reduce absorption of deferasirox
Mechanism of action:
1) binds iron, complex excreted in bile
2) less effective than Desferal
Notes: cost $3000/month (2005)
General
chelating agent
Database Correlations
PUBCHEM cid=214348
References
- Prescriber's Letter 13(1): 2006
Detail-Document#: 220106
(subscription needed) http://www.prescribersletter.com
- FDA MedWatch
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Exjade
- FDA MedWatch
Exjade (deferasirox) - Early Communication
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm183840.htm
- FDA MedWatch
Exjade (deferasirox): Boxed Warning
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200850.htm
- Prescriber's Letter 17(7): 2010
Recommended Lab Monitoring for Common Medications
Liver Function Test Scheduling
Detail-Document#: 260704
(subscription needed) http://www.prescribersletter.com