Deferasirox

EXJADE

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Pronunciation: de-FER-a-sir-ox (EX-jayd)

Deferasirox ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Deferasirox ballicule

What it isOral iron chelator; transfusional iron overload.

Why this oneOral once-daily chelation replacing overnight subcutaneous infusions.

What limits itRenal and hepatic failure and GI hemorrhage require monitoring. GI upset and rash are common.

Deferasirox molecular structure (skeletal formula) — Molecular structure: Deferasirox

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Renal failure (incl. fatal), hepatic failure (incl. fatal), and GI hemorrhage; monitor renal/hepatic function; contraindicated if eGFR <40.

FDA dosing	Population	Start	Target	Max
Transfusional iron overload	>=2 yr, eGFR >60	20 mg/kg QD	adjust q3-6 mo by ferritin trend	per titration
Non-transfusion-dependent thalassemia (NTDT) iron overload	eGFR >60	10 mg/kg QD	adjust by ferritin/LIC	per titration

Titration Adjust every 3-6 months based on serum ferritin trends.

Renal Contraindicated if eGFR <40. eGFR 40-60: reduce starting dose by 50%. Evaluate baseline renal function; monitor at least monthly.

Hepatic Severe (Child-Pugh C): avoid. Moderate (Child-Pugh B): reduce starting dose by 50%. Mild (Child-Pugh A): monitor closely.

Instructions

Take orally once daily as an oral suspension; calculate dose to nearest whole tablet.
Obtain baseline renal function (serum creatinine in duplicate), LFTs/bilirubin, auditory and ophthalmic exams before starting.

Available strengths

tab 90, 125, 180, 250, 360, 500 mg
granules 90, 180, 360 mg

Contraindications

Estimated GFR <40 mL/min/1.73 m2
Poor performance status
High-risk myelodysplastic syndrome
Advanced malignancies
Platelet count <50 x 10^9/L

Cautions

Acute kidney injury/renal failure and renal tubular toxicity (Fanconi syndrome)
Hepatic toxicity and failure
GI hemorrhage/ulceration
Bone marrow suppression
Hypersensitivity
Severe skin reactions (SJS/TEN/DRESS)
Auditory and ocular abnormalities

Adverse reactions

Diarrhea
Vomiting
Nausea
Abdominal pain
Skin rash
Increased serum creatinine

Pregnancy Use only if potential benefit justifies fetal risk; animal decreased offspring viability and renal anomalies.

Lactation Undefined

Cost

Deferasirox (EXJADE)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
90 mg	tab	30 qd		offered
125 mg	tab	30 qd		offered
180 mg	tab	30 qd	$26.25	offered
250 mg	tab	30 qd		offered
360 mg	tab	30 qd	$37.42	offered
500 mg	tab	30 qd		offered

Generic entry2016

⚠ BOXED WARNINGS

Renal failure
Hepatic failure
Gastrointestinal hemorrhage

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger3 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityAgent-specific cardiovascular, neurologic or metabolic toxicity requires monitored use in poisoning or overload.

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