Deferasirox (Oral)

Typically given after blood transfusions, Deferasirox is prescribed to patients in order to remove any excess iron from their body.

Overview

If a patient has undergone a series of blood transfusions, they may have high levels of iron in their system. As this can be dangerous, Deferasirox is given in order to remove the excess iron from the patient's system. In addition to this, Deferasirox may be given to patients who have thalassemia syndromes. In these patients, excess iron is not usually caused by blood transfusions but by their condition.

Although humans need iron in order to function effectively, it can be toxic in high levels. If patients have too much iron in their body, they may suffer from nausea, stomach pain and/or vomiting but far more serious damage is also possible. If untreated, high levels of iron accumulate in the patient's organs. As well as affecting the way the organs work, excess iron will eventually cause them to fail and irreversible damage can be caused to the liver and/or brain. Whilst an overdose of iron can be fatal in itself, high levels of iron have also been linked to an increased risk of some cancers.

Due to the potential harmful effects of high iron levels, it's vital that patients are monitored thoroughly if they have received blood transfusions. Similarly, any patients who have been diagnosed with blood conditions or iron absorption issues should undergo regular testing to ensure their levels remain at an optimal level.

If a patient has a high level of iron in their system, Deferasirox can be used to remove it. Once the medication has been taken, the active ingredient combines with iron in the patient's blood. The combination of iron and Deferasirox then passes through the kidneys and is removed from the body.

By prescribing Deferasirox to patients with high levels of iron, doctors can ensure that they do not suffer any harmful effects. Whilst blood transfusions can be a life-saving form of treatment, patients should not suffer adverse consequences as a result of too much iron being transferred to their systems. When Deferasirox is used to reduce the patient's iron levels, doctors can ensure that patients have a safe amount of iron in their blood and that they won't suffer any of the complications associated with iron overload.

Conditions Treated

  • Excess iron levels

Type of Medicine

  • Iron chelator

Side Effects

Most medicines can cause side-effects in some patients but not every patient will experience adverse effects when taking Deferasirox. In fact, patients may experience no side-effects at all when they're taking this medication or they may only experience relatively mild side-effects.

However, it is important to seek medical advice if you experience adverse effects after taking Deferasirox. When you seek help, doctors can ensure that the medication is working properly and that it isn't causing any harm to your body.

The following side-effects are fairly common when patients are taking Deferasirox but they do warrant medical attention:

  • style="font-weight: 400;">Stomach or abdominal pain
  • Diarrhea
  • Pain in the ear or earache
  • Dizziness
  • Nausea
  • Changes to voice
  • Vomiting

There are other effects which can occur when patients are taking Deferasirox to reduce the level of iron in their blood. Whilst the following side-effects are less common, patients should seek medical help if they begin to display any of the following symptoms:

  • Blurry vision
  • Blindness
  • Changes to hearing
  • Discomfort or pain in the eye
  • Changes to vision
  • Tarry, black stools
  • Blood in stools or urine
  • Bleeding gums
  • Dark urine
  • Decreased urine output
  • General feeling of weakness or tiredness
  • Hive-like swellings on the eyelids, face, tongue, lips, throat, legs, hands, feet and/or sex organs
  • Welts or hives
  • Rash on the skin
  • Lethargy
  • Pain in side or lower back
  • Yellow skin or eyes
  • Light colored stools
  • Pale skin
  • Itching, soreness or redness of the skin
  • Swelling or puffiness of the skin around the eyes, the eyelids, lips, face and/or tongue
  • Welts, sores or blisters
  • Stomach pain
  • Vomiting of material that looks like coffee grounds
  • Unusual bruising or bleeding
  • Vomiting of blood

Similarly, patients should seek medical advice if they experience any side-effects which are not listed above. In addition to this, patients can report the presence of additional side-effects to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

When patients are being treated with Deferasirox after numerous blood transfusions, a typical dose for adults is 14mg of standard Deferasirox tablets per kg of body weight on a daily basis. Although doctors may increase this dose, patients are not normally given more than 28mg per kg of body weight per day.

If patients are being treated with Deferasirox powder for suspension, however, a standard dose is slightly higher. Normally, patients are given 20mg per kg of body weight per day but their dose may be increased to a maximum of 40mg per kg of body weight per day.

Although the correct dose of Deferasirox is dependent on the patient's weight, it is doctors who will make this calculation. Patients should not, therefore, attempt to calculate their own dose of Deferasirox.

If patients are treated with Deferasirox due to thalassemia syndromes, a standard dose may be 7mg of Deferasirox per kg of body weight per day, with a maximum of 14mg per kg of bodyweight being prescribed if necessary. If Deferasirox powder for suspension is prescribed, however, patients may be given a dose of 10mg per kg of body weight per day, up to a maximum of 20mg per kg of body weight.

Although these are typical doses of Deferasirox, every patient is different and their dose will vary. Due to this, patients should always follow their doctor's instructions when taking this medication.

If patients accidentally miss a dose of Deferasirox, they should take the dose as soon as they remember to do so. However, if their next dose of medication is due soon, they will need to skip the missed dose completely. It is not appropriate to take double or extra doses of Deferasirox.

Generally, patients are advised to take standard Deferasirox tablets whole, with a glass of water. Patients are often told to take their medication at the same time each day and to take standard Deferasirox tablets on an empty stomach or after a light meal.

If patients are prescribed Deferasirox powder for suspension, they are normally told to take their medication on an empty stomach, at least thirty minutes before eating. When taking Deferasirox powder for suspension, patients should add the medication to water or juice and then mix it well. Patients should drink the mixture immediately, add some more liquid to the glass and then drink that. This ensures that no medication remains in the glass and that the patient gets the full dose of Deferasirox.

If patients are unsure how to take their medicine or when to take it, they should seek advice from their physician or pharmacist.

Potential Drug Interactions:

As some medications can interact with each other, they may not be prescribed at the same time. Usually, Deferasirox is not prescribed if patients are already taking the following medications:

  • Aluminum Carbonate, Basic
  • Warfarin
  • Aluminum Hydroxide
  • Dihydroxyaluminum Aminoacetate
  • Aluminum Oxide
  • Dihydroxyaluminum Sodium Carbonate
  • Aluminum Phosphate
  • Enzalutamide
  • Cholestyramine
  • Duloxetine
  • Colesevelam
  • Fosphenytoin
  • Colestipol
  • Phenobarbital
  • Ritonavir
  • Phenytoin
  • Theophylline
  • Rifampin
  • Tizanidine

However, even if patients are taking the above medications, doctors may prescribe Deferasirox if they feel the benefits of the treatment outweigh the risks. If necessary, doctors will alter the patient's dose of medicine to try and limit the chance of interactions occurring.

As interactions can also occur between non-prescribed medications, patients should inform their doctor if they are using any over-the-counter medicines, supplements or vitamins before taking Deferasirox. In addition to this, patients will need to access medical advice before taking these substances whilst they are taking Deferasirox.

Warnings

Before being treated with any medication, patients should discuss their medical history with their physician, if they are able to do so. There are some conditions which can affect the suitability of Deferasirox as a form of treatment. Patients should, therefore, notify their doctor if they have been diagnosed with any of the following:

Although these conditions may not prevent Deferasirox from being prescribed, patients may be given a different dose of medication if they have any of these existing conditions.

On occasion, Deferasirox can cause serious damage to the liver and/or kidneys and it may also cause bleeding in the stomach and/or intestines. If patients already have liver, kidney or stomach conditions, they may be at greater risk of these complications occurring. Patients should be made aware of these risks before taking Deferasirox.

Young patients can be prescribed Deferasirox if they require it but patients under the age of 2 years are not typically given Deferasirox to treat iron overload caused by blood transfusions. Similarly, patients under the age of 10 years are unlikely to be given Deferasirox if they have excess iron levels due to thalassemia syndromes.

Older patients can be prescribed Deferasirox but they may be given a relatively low starting dose of medication. As geriatric patients often have existing liver and/or kidney problems, it may take longer for them to process the medication. Due to this, physicians are likely to prescribe a low dose of Deferasirox and increase the dose if necessary, once their response to the medication has been determined.

The safety of Deferasirox for pregnant patients cannot be guaranteed and pregnant patients should only be given this medication if the benefits clearly outweigh any risks. If patients are pregnant, they should discuss this with their doctor before taking Deferasirox.

Deferasirox can affect the way that birth control medications work. Patients should, therefore, use additional birth control medications when taking Deferasirox. If patients become pregnant when taking Deferasirox, they should contact their doctor for medical advice.

As medicines can pass from a patient to an infant via breastfeeding, patients are generally advised not to breastfeed whilst taking Deferasirox. Similarly, they should not breastfeed for some time after their last dose of Deferasirox as the medication may still be in their system. Patients should discuss this with their doctor before taking Deferasirox or breastfeeding.

When taking Deferasirox, patients should have regular consultations with their physician to ensure that the medication is working correctly and that they are not suffering from any potentially harmful effects.

Some patients may begin to experience vision or hearing problems whilst taking Deferasirox. Typically, these issues begin within a few weeks of taking the medicine and may include blurred vision, difficulty seeing at night and/or difficulty seeing colors. If patients experience any hearing or vision problems whilst taking this medication, they should contact their physician as quickly as possible.

Deferasirox affects the patient's blood cells and, whilst taking the medication, patients may have a decreased number of some cells in their blood. Due to this, patients may be more susceptible to infections and they may bleed more easily.

Due to this, patients will need to try and avoid contracting any illnesses or infections and avoid cuts and lacerations where possible. Patients should avoid taking part in contact sports, for example, and these may increase the chance of injuries occurring and patients should take extra care when brushing their teeth as this could cause the gums to bleed.

If Deferasirox has a negative effect on the patient's kidneys, it may be displayed by the following symptoms occurring:

  • Swelling of the ankles, fact and/or hands
  • Lethargy
  • Agitation
  • Muscle twitching
  • Weight gain (rapid)
  • Seizures
  • Confusion
  • Decreased urination

If patients experience these side-effects, they should seek urgent medical attention.

Deferasirox can also have a negative effect on the liver. If patients experience this, they may exhibit the following

symptoms:

  • Lack of appetite
  • Dark urine
  • Nausea
  • Yellow skin or eyes
  • Unusual tiredness
  • Pale stools
  • Upper stomach pain

If patients display these symptoms, they should seek immediate medical help.

When taking Deferasirox, symptoms of a serious bowel or stomach problem may include:

  • Nausea
  • Vomiting of blood or what looks like coffee grounds
  • Abdominal or stomach pain, burning or cramping
  • Tarry, black stools
  • Diarrhea
  • 400;">Constipation
  • 400;">Indigestion
  • 400;">Heartburn

If patients experience these side-effects when taking Deferasirox, they will need to access immediate medical advice.

Deferasirox can also cause serious skin reactions in some patients. These require urgent treatment and may be characterized by:

  • Peeling, loosening or blistering of the skin
  • Red lesions on the skin
  • Ulcers or sores
  • Chills or fever

When taking Deferasirox, patients may experience dizziness. If so, patients should avoid driving, operating heavy machinery or carrying out tasks which require their full attention.

Patients should not take any medicines, supplements and/or vitamins which contain aluminum whilst receiving treatment with Deferasirox. This includes antacids which typically contain aluminum.

Before taking Deferasirox, patients should discuss any allergies they have with their physician. In rare cases, this medication may cause patients to suffer a serious allergic reaction, including anaphylaxis. This is a life-threatening situation and should be treated as a medical emergency. Symptoms may include:

  • Hoarseness
  • Rash on skin
  • Itching
  • Difficulty breathing
  • Difficulty swallowing
  • Swelling of the face, throat, lips and or hands.

Storage

Unless otherwise advised, patients should keep their medication at room temperature and keep their stock of Deferasirox away from direct light, heat, and moisture. When storing medications at home, patients should use a locked cabinet or secure container so that no-one else has access to the medicine.

If patients have children and/or pets in the home, it is extremely important that Deferasirox is kept out of their reach.

If patients are advised to stop taking Deferasirox or if they medication reaches its use-by date, it will need to be disposed of. Patients should not throw Deferasirox out with other household waste. Instead, patients should contact their physician's office or pharmacist in order to access an appropriate and safe disposal method.

Summary

If patients have excessively high levels of iron in their blood, it can cause serious health complications. If left untreated, high iron levels may even be fatal in some cases. It's essential, therefore, that physicians are able to reduce the amount of iron in the patient's system when it is necessary to do so.

As Deferasirox binds with iron in the patient's blood, it facilitates the removal of these cells and ensures that the patient's iron levels are reduced accordingly. As patients may have excess iron in their system after receiving numerous transfusions, this is the most common instance in which Deferasirox is prescribed.

Although treatment with Deferasirox does carry some risks, careful monitoring can help to prevent the patient from suffering any complications. Furthermore, using Deferasirox to reduce the amount of iron in the patient's blood can help them to avoid serious damage to their liver and/or brain.