| Common Brands | Exjade, Jadenu (newer formulation) |
|---|---|
|
Drug Class |
Iron Chelator |
|
Controlled Substance Classification |
Not a controlled medication |
|
Generic Status |
Lower-cost generic available |
|
Availability |
Prescription only |
Exjade is a prescription medication used to treat chronic iron overload in people who receive regular blood transfusions. It is also used in patients with non–transfusion-dependent thalassemia syndromes who have too much iron in their body. Iron overload occurs when the body absorbs or receives more iron than it can use, which can damage the heart, liver, and other organs over time.
Exjade contains the active ingredient deferasirox, which is an oral iron chelator. It works by binding to excess iron in the body and helping remove it through the stool. Unlike traditional iron chelation therapies that require injection, Exjade is taken by mouth, making it more convenient for long-term treatment.
Exjade is usually prescribed for people with conditions like thalassemia, sickle cell anemia, or other chronic anemias that require frequent transfusions. By lowering iron levels, Exjade helps prevent serious organ damage and improves long-term health outcomes.
Administration: Exjade comes in tablet form that must be dispersed in water, orange juice, or apple juice before being taken. Do not chew or swallow whole. Stir the tablet until it forms a fine suspension, then drink it immediately. Rinse the glass with a small amount of liquid and drink that too to ensure the full dose is consumed.
Timing: Take Exjade once daily, on an empty stomach, either at least 30 minutes before food or 2 hours after eating.
Hydration: Drink plenty of water daily unless otherwise directed, as this supports kidney function and reduces the risk of side effects.
Duration: Exjade is a long-term therapy. Treatment is continued until iron levels return to safe ranges. Do not stop using it without consulting your healthcare provider.
Exjade works as an iron chelator, which means it binds to excess iron in the bloodstream and carries it out of the body.
After repeated blood transfusions, iron starts to build up in tissues and organs because the body has no natural way to get rid of it. Too much iron can lead to complications like liver disease, heart problems, and hormonal imbalances.
Deferasirox, the active ingredient in Exjade, binds to iron molecules in the blood. The iron-deferasirox complex is then eliminated through the stool. This reduces the total iron burden in the body over time.
Exjade is specifically designed to target non-heme iron, which is the form of iron not bound to hemoglobin. It is selective and does not interfere significantly with normal iron used by red blood cells.
Common Side Effects
Nausea and Vomiting: Some people may feel queasy or vomit, especially during the early stages of treatment.
Diarrhea or Abdominal Pain: These digestive issues may occur but often improve with time.
Skin Rash: Mild allergic reactions may cause rash or itching.
Headache: A common but generally mild complaint.
Increased Liver Enzymes: Regular monitoring is required to check for potential liver stress.
Serious Side Effects
Kidney Problems: Exjade can affect kidney function. Symptoms include reduced urination, swelling, or fatigue. Routine blood tests are important to monitor kidney health.
Liver Damage: In rare cases, Exjade may cause serious liver injury. Signs include yellowing of the skin or eyes, dark urine, and upper abdominal pain.
Hearing and Vision Changes: High doses or long-term use may lead to hearing or vision issues. Report any unusual symptoms right away.
Gastrointestinal Bleeding: Though rare, serious bleeding can occur, especially in older adults or those with existing stomach conditions.
Severe Allergic Reactions: Symptoms like swelling of the face, difficulty breathing, or severe rash require immediate medical attention.
If any side effects are severe or persistent, speak to your healthcare provider immediately.
Because of the risks associated with Exalgo, it comes with several important warnings:
Pregnancy and Breastfeeding:
Exalgo should only be used under strict medical supervision and for its intended purpose.
Medical Conditions: Use Exjade cautiously in people with kidney or liver disease, gastrointestinal disorders, or low platelet counts. Regular lab tests are necessary.
Pregnancy and Breastfeeding: The effects of Exjade on unborn babies are unknown. It should only be used during pregnancy if clearly needed. It is not known whether Exjade passes into breast milk.
Overuse: Taking too much Exjade can cause serious liver or kidney damage. Always follow your doctor’s instructions and never take more than prescribed.
Alcohol: Avoid alcohol, as it can increase the risk of liver damage and worsen side effects.
Monitoring: Regular monitoring of serum ferritin, liver function, kidney function, and blood counts is essential during Exjade treatment.
For safe and effective use:
Transfusion-related iron overload:
Start with 20 mg/kg once daily, adjust based on serum ferritin and treatment response. Dosage range is usually between 10–30 mg/kg daily.
Non–transfusion-dependent thalassemia:
Start with 10 mg/kg once daily, and adjust as needed. Maximum dose is 20 mg/kg daily.
Regular blood tests will help determine whether the dose should be increased, reduced, or maintained. Never change the dose without your doctor’s approval.
If you miss a dose, take it as soon as you remember. If it’s close to your next dose, skip the missed dose. Do not double up.
Exjade is a prescription-only medication and must be prescribed by a healthcare professional. It is not available over the counter.
Consult Your Healthcare Provider: Before starting Exjade, undergo a full medical evaluation, including liver and kidney tests, and discuss any other health conditions or medications.
Follow Dosage Instructions: Always take Exjade exactly as prescribed. Do not adjust the dose or stop treatment without medical advice.
Monitor Your Health: Routine blood tests will help track iron levels, organ function, and possible side effects. Keep regular appointments and report any unusual symptoms right away.
With proper use and monitoring, Exjade helps manage iron overload effectively and improves long-term health outcomes for patients who rely on regular transfusions or absorb too much iron naturally.
What is Exjade used for?
It is prescribed to treat chronic iron overload in people receiving frequent blood transfusions (transfusional hemosiderosis) or in certain anemias not requiring transfusion.
What is the active ingredient?
Deferasirox, an iron chelator.
How does Exjade work?
It binds to excess iron in the body, allowing it to be excreted mainly through stool.
How is Exjade taken?
Taken once daily by mouth, usually on an empty stomach, at least 30 minutes before food.
What forms does it come in?
Available as dispersible tablets that must be dissolved in liquid before swallowing. (Note: newer formulation Jadenu® comes as film-coated tablets).
Who needs Exjade?
Patients with thalassemia, sickle cell disease, myelodysplastic syndromes, or other chronic anemias that cause iron buildup from transfusions.
How long does it take to work?
Iron levels decrease gradually—several weeks to months of regular use may be required.
What are the common side effects?
Nausea, vomiting, diarrhea, abdominal pain, rash, and headache.
Are there serious side effects?
Yes, possible kidney failure, liver failure, gastrointestinal bleeding, hearing loss, or vision changes.
How often are lab tests needed?
Regular monitoring of liver function, kidney function, and ferritin/iron levels is required.
Can Exjade cause hearing or vision problems?
Yes, long-term use can rarely cause hearing loss or vision changes—eye and ear exams are recommended.
Is it safe for children?
Yes, it can be prescribed for children aged 2 years and older, with dosing adjusted by weight.
Is Exjade safe during pregnancy?
Not usually recommended—should only be used if benefits outweigh risks.
Can I take Exjade while breastfeeding?
Not recommended, as it is unknown if the drug passes into breast milk.
Does Exjade interact with other medicines?
Yes—especially NSAIDs, anticoagulants, corticosteroids, and certain blood pressure or seizure medications.
Can I drink alcohol while taking Exjade?
Avoid alcohol—it increases the risk of liver problems.
What should I do if I miss a dose?
Take it as soon as possible the same day, but do not double the next dose.
Can I crush or chew Exjade tablets?
No, dispersible tablets must be dissolved in water, juice, or apple sauce before taking.
Is there a generic version available?
Yes, generic deferasirox is available.
Where can I get Exjade?
Available at pharmacies with a prescription, often through specialty pharmacies.
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