Deferasirox Jubilant: Uses, Dosage & Side Effects
An oral iron chelating agent used to reduce chronic iron overload caused by repeated blood transfusions in conditions such as thalassemia, sickle cell disease, and myelodysplastic syndromes
Deferasirox Jubilant is an oral iron chelating medication containing the active substance deferasirox. It is prescribed for the treatment of chronic iron overload caused by frequent blood transfusions (transfusional hemosiderosis) in patients aged 6 years and older. Iron overload develops when patients with conditions such as beta-thalassemia major, sickle cell disease, or myelodysplastic syndromes receive regular blood transfusions that gradually accumulate excess iron in vital organs. Deferasirox works by selectively binding to iron in the bloodstream and promoting its removal from the body primarily through the feces, thereby preventing iron-related damage to the heart, liver, and endocrine organs. Deferasirox Jubilant is a generic formulation available as 90 mg film-coated tablets that are taken once daily by mouth.
Quick Facts: Deferasirox Jubilant
Key Takeaways
- Deferasirox Jubilant is an oral iron chelator that removes excess iron from the body, primarily excreted through the feces, reducing the need for subcutaneous deferoxamine infusions.
- Film-coated tablets are swallowed whole once daily and have approximately 36% higher bioavailability than the older dispersible tablet formulation, requiring different dosing.
- Regular monitoring of kidney function (serum creatinine), liver enzymes, and serum ferritin is mandatory throughout treatment to ensure safety.
- The starting dose for transfusion-dependent patients is typically 14 mg/kg/day, adjusted every 3–6 months based on serum ferritin trends and transfusion iron intake.
- Deferasirox can cause serious renal, hepatic, and gastrointestinal adverse effects; early detection through regular blood tests is essential for safe, long-term use.
What Is Deferasirox Jubilant and What Is It Used For?
Deferasirox Jubilant contains the active substance deferasirox, a tridentate iron chelator that was first approved by regulatory authorities in 2005 and has since become one of the most widely used oral iron chelation therapies worldwide. Iron chelation therapy is essential for patients who receive regular blood transfusions, as the human body has no efficient physiological mechanism for excreting excess iron. Without chelation treatment, iron accumulates progressively in the heart, liver, and endocrine glands, eventually causing organ failure and potentially death.
The primary indication for Deferasirox Jubilant is the treatment of chronic iron overload due to frequent blood transfusions (transfusional hemosiderosis) in patients aged 6 years and older. This encompasses a broad range of conditions requiring chronic transfusion therapy, including beta-thalassemia major, sickle cell disease, myelodysplastic syndromes (MDS), Diamond-Blackfan anemia, and other rare inherited or acquired anemias. Patients with these conditions may receive transfusions every 2–4 weeks, with each unit of red blood cells delivering approximately 200–250 mg of iron that the body cannot eliminate naturally.
Deferasirox Jubilant is also indicated for the treatment of chronic iron overload requiring chelation therapy when deferoxamine therapy is contraindicated or inadequate. Deferoxamine, the traditional iron chelator, requires prolonged subcutaneous or intravenous infusions lasting 8–12 hours, which significantly impacts patient quality of life and adherence. Deferasirox offers the major advantage of once-daily oral dosing, which has been shown to improve treatment compliance substantially.
Additionally, deferasirox is approved for non-transfusion-dependent thalassemia (NTDT) syndromes when iron overload develops due to increased intestinal iron absorption. In these patients, iron accumulates more slowly than in transfusion-dependent patients but can still reach levels that cause significant organ damage over time. Treatment in NTDT is typically initiated when serum ferritin exceeds 800 µg/L and liver iron concentration exceeds 5 mg Fe/g dry weight.
How Does Deferasirox Work?
Deferasirox is a highly selective oral iron chelator belonging to the triazole class. Each molecule of deferasirox contains three atoms that can bind to iron (making it a tridentate chelator), and two molecules of deferasirox are needed to fully enclose and neutralize one atom of ferric iron (Fe3+), forming a stable 2:1 complex. This iron-deferasirox complex is then excreted from the body primarily through the feces (approximately 84% of the chelated iron), with minimal renal excretion.
An important pharmacological advantage of deferasirox is its selectivity for iron over other essential divalent metal ions. At therapeutic doses, deferasirox does not significantly chelate zinc or copper, which are essential trace elements required for normal physiological processes. This selectivity reduces the risk of deficiency states that can occur with less selective chelators. The elimination half-life of deferasirox is 8–16 hours, which supports effective once-daily dosing and provides continuous iron chelation coverage throughout the day.
What Should You Know Before Taking Deferasirox Jubilant?
Contraindications
Deferasirox Jubilant must not be used in certain clinical situations where the risks clearly outweigh the benefits. These absolute contraindications include hypersensitivity to deferasirox or any of the excipients in the formulation. The drug is also contraindicated in combination with other iron chelating therapies, as the safety of such combinations has not been established and could lead to excessive metal depletion.
Patients with an estimated creatinine clearance (CrCl) below 40 mL/min should not take deferasirox, as impaired renal excretion can lead to drug accumulation and increased toxicity. Additionally, deferasirox is contraindicated in patients with severe hepatic impairment (Child-Pugh Class C), as the drug is extensively metabolized in the liver. Patients with advanced malignancies where life expectancy is limited and where iron chelation would not provide meaningful clinical benefit should also generally not receive deferasirox.
Do not take Deferasirox Jubilant if you have: severe kidney impairment (CrCl < 40 mL/min), severe liver disease (Child-Pugh C), or known allergy to deferasirox. Do not combine with other iron chelators unless specifically directed by your specialist.
Warnings and Precautions
Deferasirox requires careful clinical monitoring due to its potential for serious adverse effects on the kidneys, liver, and gastrointestinal tract. Before initiating treatment, a baseline assessment must include serum creatinine (measured twice), estimated glomerular filtration rate (eGFR), liver function tests (ALT, AST, bilirubin, alkaline phosphatase), serum ferritin, complete blood count, and a urine protein-to-creatinine ratio.
Renal toxicity is one of the most significant concerns with deferasirox. The drug can cause dose-dependent increases in serum creatinine, renal tubular dysfunction (including Fanconi syndrome with aminoaciduria, phosphaturia, and glycosuria), and, in rare cases, acute kidney injury requiring temporary or permanent discontinuation. Risk factors for renal complications include pre-existing kidney impairment, dehydration, concomitant use of nephrotoxic drugs, and advanced age. Serum creatinine must be monitored weekly during the first month, then monthly thereafter.
Hepatotoxicity has been reported, including increases in hepatic transaminases, hepatic failure, and fatal outcomes. Liver function tests should be checked before starting treatment, every 2 weeks during the first month, and then monthly. If persistent and progressive increases in hepatic transaminases are not attributable to other causes, deferasirox should be interrupted or discontinued. The drug should be used with caution in patients with pre-existing liver disease.
Gastrointestinal effects include upper GI ulceration and hemorrhage, which have been reported and can be fatal, particularly in elderly patients with advanced hematologic malignancies and low platelet counts. Physicians should monitor for signs of GI bleeding, and patients should be advised to report any abdominal pain, hematemesis, or melena immediately.
Serum creatinine: weekly for first month, then monthly. Liver function tests: every 2 weeks for first month, then monthly. Serum ferritin: monthly. Audiometry and ophthalmology: annually. Report any hearing changes, visual disturbances, or abdominal pain immediately.
Pregnancy and Breastfeeding
Deferasirox should not be used during pregnancy unless clearly necessary and the potential benefit justifies the potential risk to the fetus. Animal reproduction studies have shown evidence of developmental toxicity, including skeletal malformations and reduced fetal weight, at doses equivalent to or below the maximum recommended human dose. There are no adequate and well-controlled studies in pregnant women. Women of childbearing potential should use effective contraception during treatment.
It is not known whether deferasirox or its metabolites are excreted in human breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue breastfeeding or to discontinue the drug, taking into account the importance of the medicine to the mother. Given the long half-life and extensive protein binding of deferasirox, excretion into breast milk cannot be ruled out.
Elderly Patients
Elderly patients (65 years and older) may be at increased risk for adverse reactions, particularly renal impairment and gastrointestinal hemorrhage. Clinical trials have shown a higher frequency of adverse events in elderly patients compared to younger adults. Dose selection should be cautious, typically starting at the low end of the dosing range, and renal function should be monitored more frequently. Adequate hydration should be maintained, and concomitant use of nephrotoxic agents should be avoided when possible.
How Does Deferasirox Jubilant Interact with Other Drugs?
Deferasirox is metabolized primarily by UDP-glucuronosyltransferases (UGT1A1 and UGT1A3), with minor contributions from cytochrome P450 enzymes, particularly CYP1A2. However, deferasirox itself significantly influences the activity of several CYP enzymes, leading to important pharmacokinetic interactions that must be managed clinically. Understanding these interactions is essential for safe prescribing, as many patients requiring iron chelation therapy also take multiple other medications for their underlying conditions.
Major Interactions
| Interacting Drug | Mechanism | Clinical Effect | Recommendation |
|---|---|---|---|
| Theophylline | CYP1A2 inhibition by deferasirox | Increased theophylline levels (up to 2-fold) | Avoid combination or reduce theophylline dose by 50%; monitor levels closely |
| Repaglinide | CYP2C8 inhibition by deferasirox | Increased repaglinide exposure; risk of hypoglycemia | Avoid combination; consider alternative antidiabetic agent |
| Aluminum-containing antacids | Chelation of aluminum by deferasirox | Reduced deferasirox efficacy; unknown effect of aluminum chelation | Do not take together; separate administration is not recommended |
| NSAIDs (e.g., ibuprofen) | Additive nephrotoxicity and GI toxicity | Increased risk of renal impairment and GI bleeding | Use with caution; monitor renal function closely if combination unavoidable |
| Corticosteroids (systemic) | Additive GI toxicity | Increased risk of GI ulceration and hemorrhage | Monitor for GI symptoms; use gastroprotective agents if needed |
| Anticoagulants (warfarin) | Additive bleeding risk | Increased risk of GI hemorrhage | Monitor INR closely; watch for signs of bleeding |
Minor Interactions
Deferasirox is a moderate inducer of CYP3A4, which means it can reduce the plasma concentrations of drugs metabolized by this enzyme. This is particularly relevant for hormonal contraceptives (both oral and non-oral), where reduced efficacy could lead to unplanned pregnancy. Women taking hormonal contraception should discuss alternative or additional contraceptive methods with their healthcare provider. The levels of midazolam (a sensitive CYP3A4 substrate) can be reduced by approximately 17% when co-administered with deferasirox.
Cyclosporine exposure may be decreased by approximately 18% when administered together with deferasirox. In transplant patients or those receiving cyclosporine for other indications, closer monitoring of cyclosporine blood levels is recommended. The exposure of paclitaxel can also be affected, and oncologists should be aware of this interaction when planning chemotherapy regimens in iron-overloaded patients.
Cholestyramine and other bile acid sequestrants may reduce the bioavailability of deferasirox by binding to it in the gastrointestinal tract. If concomitant use is necessary, deferasirox should be taken at least 2 hours before or 4 hours after the bile acid sequestrant. Similarly, high-fat meals can increase the bioavailability of deferasirox film-coated tablets by approximately 18%, which is generally not clinically significant but should be considered when evaluating variable drug responses.
What Is the Correct Dosage of Deferasirox Jubilant?
Dosing of Deferasirox Jubilant film-coated tablets differs from the older dispersible tablet formulation due to significantly higher bioavailability (approximately 36% greater exposure). It is critically important that healthcare providers and patients do not interchange these formulations on a milligram-for-milligram basis. The dose conversion factor is approximately 0.7, meaning that patients switching from dispersible tablets to film-coated tablets should receive 70% of the dispersible tablet dose (e.g., 20 mg/kg/day dispersible = 14 mg/kg/day film-coated).
Adults
Transfusion-Dependent Iron Overload
Starting dose: 14 mg/kg/day orally once daily
Dose adjustment: May increase by 3.5–7 mg/kg/day every 3–6 months if serum ferritin does not show a downward trend and the patient continues to receive transfusions
Maximum dose: 28 mg/kg/day
Dose reduction: Consider reducing by 3.5–7 mg/kg when serum ferritin falls below 1,000 µg/L. Stop treatment if ferritin falls below 500 µg/L
Administration: Swallow tablets whole with water, once daily at the same time. Can be taken with or without a light meal
Non-Transfusion-Dependent Thalassemia (NTDT)
Starting dose: 7 mg/kg/day orally once daily
Dose adjustment: May increase to 14 mg/kg/day after 3–6 months if liver iron concentration (LIC) > 7 mg Fe/g dw and serum ferritin > 2,000 µg/L
Maximum dose: 14 mg/kg/day for NTDT
Stop treatment: When LIC falls below 3 mg Fe/g dw or serum ferritin falls below 300 µg/L
Children (6 Years and Older)
Children aged 6 years and older follow the same weight-based dosing as adults for film-coated tablets. The starting dose is 14 mg/kg/day for transfusion-dependent iron overload. However, pediatric patients tend to have higher drug clearance per kilogram of body weight, and some children may require doses at the higher end of the dosing range to achieve adequate iron chelation. Close monitoring of growth parameters and pubertal development is recommended, as iron overload itself can impair growth and sexual maturation.
Children aged 2–5 years may only use the dispersible tablet formulation (not the film-coated tablets). The film-coated tablet formulation has not been studied in children under 6 years, and the tablets cannot be divided or crushed for dose adjustment in younger children. Deferasirox in any formulation is not recommended for children under 2 years of age due to insufficient safety and efficacy data.
| Patient Group | Starting Dose | Maximum Dose | Key Notes |
|---|---|---|---|
| Adults (transfusion-dependent) | 14 mg/kg/day | 28 mg/kg/day | Adjust every 3–6 months based on ferritin |
| Adults (NTDT) | 7 mg/kg/day | 14 mg/kg/day | Only if LIC > 5 mg Fe/g dw and ferritin > 800 µg/L |
| Children ≥ 6 years | 14 mg/kg/day | 28 mg/kg/day | May need higher doses; monitor growth |
| Elderly (≥ 65 years) | 14 mg/kg/day | 28 mg/kg/day | Start low, monitor renal function closely |
| Renal impairment (mild–moderate) | 7 mg/kg/day | 14 mg/kg/day | CrCl 40–60 mL/min: reduce dose by 50% |
Elderly
Elderly patients follow the same general dosing principles but should be started at the lower end of the dose range due to the greater frequency of decreased renal and hepatic function, as well as the higher incidence of gastrointestinal bleeding in older adults. For patients aged 65 years and older, it is particularly important to ensure adequate hydration and to monitor renal function more frequently (every 2 weeks during the first 3 months, then monthly). Concomitant medications should be reviewed carefully for nephrotoxic or hepatotoxic potential.
Missed Dose
If a dose of Deferasirox Jubilant is missed, it should be taken as soon as the patient remembers, as long as it is not close to the time for the next dose. Patients should not take a double dose to make up for a missed dose, as this can increase the risk of adverse effects, particularly gastrointestinal and renal side effects. If a dose is missed entirely, treatment should continue with the next scheduled dose. Patients should be advised to take their medication at the same time each day to help establish a routine and minimize missed doses.
Overdose
Cases of deferasirox overdose have been reported. Symptoms of acute overdose may include nausea, vomiting, diarrhea, abdominal pain, and acute renal injury. In the event of overdose, there is no specific antidote. Treatment is symptomatic and supportive, including monitoring of renal and hepatic function, fluid replacement, and general supportive measures. Deferasirox is highly protein-bound and is unlikely to be significantly removed by hemodialysis. Patients who have taken an overdose should seek immediate medical attention, and their treating physician should be contacted.
What Are the Side Effects of Deferasirox Jubilant?
Like all medicines, Deferasirox Jubilant can cause side effects, although not everybody gets them. The safety profile of deferasirox has been well characterized through extensive clinical trials involving over 5,500 patients and over 15 years of post-marketing surveillance. The most common adverse reactions are gastrointestinal in nature and are often manageable with dose adjustments and supportive measures. Understanding the frequency and nature of these effects helps patients and clinicians to monitor appropriately and intervene early when necessary.
Side effects are classified below according to their frequency of occurrence in clinical trials and post-marketing reports. It is important to note that many side effects are dose-dependent and may improve with dose reduction. Patients should be encouraged to report any new or worsening symptoms to their healthcare team promptly, particularly symptoms affecting the kidneys (changes in urine output, swelling), liver (jaundice, dark urine), or gastrointestinal tract (abdominal pain, blood in stool).
Very Common (affects more than 1 in 10 patients)
Reported in > 10% of patients in clinical trials
- Increased serum creatinine (dose-dependent, usually mild and reversible)
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain (upper abdominal pain, stomach discomfort)
Common (affects 1 to 10 in 100 patients)
Reported in 1–10% of patients in clinical trials
- Headache
- Skin rash (including maculopapular, erythematous, and pruritic rashes)
- Pruritus (itching)
- Increased hepatic transaminases (ALT and/or AST elevation)
- Proteinuria (protein in urine)
- Abdominal distension, constipation, dyspepsia
- Fatigue
Uncommon (affects 1 to 10 in 1,000 patients)
Reported in 0.1–1% of patients
- Anxiety, sleep disorder
- Dizziness
- Cataract, maculopathy, hearing loss
- Gastrointestinal hemorrhage (including gastric ulcer)
- Hepatitis, cholelithiasis (gallstones)
- Pigmentation disorder, urticaria
- Renal tubular disorder (Fanconi syndrome)
- Fever, edema, fatigue
Rare (affects 1 to 10 in 10,000 patients)
Reported in 0.01–0.1% of patients
- Acute kidney injury (may require dialysis)
- Hepatic failure (potentially fatal)
- Stevens-Johnson syndrome (SJS)
- Erythema multiforme
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Optic neuritis
- Metabolic acidosis
- Acute pancreatitis
Not Known (frequency cannot be estimated)
Reported from post-marketing surveillance
- Toxic epidermal necrolysis (TEN)
- Hyperammonemic encephalopathy
- Worsening of pre-existing cytopenia (rare, in MDS patients)
Contact your doctor or go to the emergency department immediately if you experience: severe abdominal pain or vomiting blood, dark or bloody stools, yellowing of the skin or eyes (jaundice), severe skin rash with blistering, significant decrease in urine output, sudden hearing loss, or vision changes.
The gastrointestinal side effects of deferasirox are among the most frequently reported and can significantly impact quality of life and treatment adherence. These effects are often most pronounced during the first few weeks of treatment and may diminish over time. Taking the medication with food, starting at a lower dose, and gradually titrating upward can help reduce gastrointestinal intolerance. If severe or persistent, a dose reduction should be considered before discontinuing therapy, as maintaining some level of iron chelation is preferable to none.
Renal side effects warrant particular attention because deferasirox-related increases in serum creatinine are very common and may progress to clinically significant renal impairment in a subset of patients. The mechanism is not fully understood but may involve tubuloglomerular feedback and direct tubular toxicity. Most serum creatinine increases remain within the upper limit of normal and stabilize over time, but periodic assessment is essential to identify the minority of patients who develop progressive renal decline. Adequate hydration is an important supportive measure that may help mitigate renal effects.
How Should You Store Deferasirox Jubilant?
Proper storage of medications is essential to ensure they remain effective and safe throughout their shelf life. Deferasirox Jubilant film-coated tablets should be stored at temperatures not exceeding 30°C (86°F). The tablets should be kept in their original blister packaging until the time of use, as this protects them from moisture and light exposure that could degrade the active substance.
Do not store Deferasirox Jubilant in the bathroom, near a kitchen sink, or in any other damp or humid environment, as moisture can affect the integrity of the film-coated tablets. Keep the medication out of sight and reach of children at all times. If a child accidentally ingests deferasirox, seek medical attention immediately, as overdose can cause serious kidney and gastrointestinal effects.
Check the expiry date on the blister pack and outer carton before taking each tablet. Do not use Deferasirox Jubilant after the expiry date stated on the packaging. Medicines should not be disposed of via household waste or wastewater. Ask your pharmacist how to properly dispose of medicines you no longer need. These measures help to protect the environment and ensure patient safety.
What Does Deferasirox Jubilant Contain?
Active Ingredient
The active substance is deferasirox. Each film-coated tablet contains 90 mg of deferasirox. Deferasirox is a synthetic tridentate iron chelator with the chemical name 4-[3,5-bis(2-hydroxyphenyl)-1H-1,2,4-triazol-1-yl]benzoic acid. It has a molecular formula of C21H15N3O4 and a molecular weight of 373.36 g/mol. The substance appears as a white to slightly yellow powder that is practically insoluble in water at physiological pH values.
Inactive Ingredients (Excipients)
- Tablet core: Microcrystalline cellulose, crospovidone, sodium laurilsulfate, magnesium stearate, colloidal anhydrous silica
- Film-coating: Hypromellose, titanium dioxide (E171), macrogol, talc, indigo carmine aluminum lake (E132)
Patients with known hypersensitivity to any of the listed excipients should inform their prescriber before starting treatment. The film-coated tablets contain sodium laurilsulfate, which may rarely cause allergic reactions. The tablets also contain a small amount of sodium (less than 1 mmol per tablet), meaning they are essentially sodium-free.
Appearance
Deferasirox Jubilant 90 mg film-coated tablets are blue, oval-shaped, biconvex tablets. They are supplied in aluminum/aluminum blister packs within cardboard outer cartons. Each tablet is marked for identification purposes. The tablets should be swallowed whole and must not be crushed, chewed, or broken before ingestion, as this may alter the drug release characteristics and bioavailability.
Manufacturer
Deferasirox Jubilant is manufactured by Jubilant Pharmaceuticals. The product is a generic formulation of deferasirox, which was originally developed and marketed by Novartis under the brand names Exjade (dispersible tablets for oral suspension, approved 2005) and Jadenu (film-coated tablets, approved 2015). Deferasirox Jubilant has been approved based on demonstration of bioequivalence to the reference product, confirming that it delivers the same therapeutic effect.
Frequently Asked Questions About Deferasirox Jubilant
Deferasirox Jubilant is an iron chelating agent used to treat chronic iron overload caused by frequent blood transfusions (transfusional hemosiderosis) in patients aged 6 years and older. It is commonly prescribed for patients with beta-thalassemia major, sickle cell disease, myelodysplastic syndromes, and other conditions requiring regular transfusions. It is also approved for non-transfusion-dependent thalassemia syndromes with elevated iron levels. The medication binds excess iron in the body and promotes its removal through the stool.
Deferasirox Jubilant film-coated tablets should be swallowed whole with water, once daily at the same time each day. They can be taken with or without a light meal. Unlike the older dispersible tablet form of deferasirox, these film-coated tablets must not be chewed, crushed, or dissolved in liquid. The dosing for film-coated tablets is different from dispersible tablets – they are not interchangeable on a milligram-for-milligram basis due to different bioavailability.
Regular blood monitoring is essential. Serum creatinine must be checked before starting treatment, weekly during the first month, then monthly. Liver function tests (ALT, AST, bilirubin) should be measured before treatment, every 2 weeks during the first month, then monthly. Serum ferritin should be tested monthly to guide dose adjustments. Complete blood counts and urinary protein should also be monitored regularly. Additionally, annual hearing tests (audiometry) and eye examinations (ophthalmoscopy) are recommended to detect rare sensory adverse effects early.
Yes, kidney effects are among the most common side effects of deferasirox. Mild increases in serum creatinine occur in over 10% of patients and are usually dose-dependent and reversible. However, more serious renal complications including renal tubular disorders (Fanconi syndrome) and, rarely, acute kidney injury can occur. Risk factors include pre-existing kidney impairment, dehydration, and use of other nephrotoxic drugs. Adequate fluid intake and regular monitoring of kidney function are essential throughout treatment.
Deferasirox Jubilant is a generic version of deferasirox, the same active substance found in the originator brands Exjade (dispersible tablets) and Jadenu (film-coated tablets). The Jubilant film-coated tablets are bioequivalent to Jadenu. An important difference is that the film-coated tablet has approximately 36% higher bioavailability than the dispersible tablet, so different doses are used: 14 mg/kg/day starting dose for film-coated tablets versus 20 mg/kg/day for dispersible tablets. Both formulations achieve equivalent iron chelation when dosed correctly.
Deferasirox Jubilant film-coated tablets are approved for children aged 6 years and older with transfusional iron overload. Children under 6 years may only use the dispersible tablet formulation. The dosing in children follows the same weight-based principles as in adults (starting at 14 mg/kg/day), but children often require higher doses per kilogram to achieve adequate iron chelation due to higher metabolic clearance. Growth and pubertal development should be monitored, as both iron overload and chelation therapy can affect these.
References
- European Medicines Agency (EMA). Deferasirox – Summary of Product Characteristics (SmPC). Last updated 2025. Available from: EMA EPAR.
- U.S. Food and Drug Administration (FDA). Jadenu (deferasirox) Prescribing Information. Revised 2024. Available from: FDA Drug Label.
- Cappellini MD, Cohen A, Eleftheriou A, et al. Guidelines for the Management of Transfusion Dependent Thalassaemia (TDT). 4th ed. Nicosia: Thalassaemia International Federation (TIF); 2021.
- Cappellini MD, Porter J, El-Beshlawy A, et al. Tailoring iron chelation by iron intake and serum ferritin: the prospective EPIC study of deferasirox in 1744 patients with transfusion-dependent anemias. Haematologica. 2010;95(4):557–566. doi:10.3324/haematol.2009.014696.
- Pennell DJ, Porter JB, Piga A, et al. A 1-year randomized controlled trial of deferasirox vs deferoxamine for myocardial iron removal in β-thalassemia major (CORDELIA). Blood. 2014;123(10):1447–1454. doi:10.1182/blood-2013-04-497842.
- Taher AT, Porter JB, Viprakasit V, et al. Deferasirox effectively reduces iron overload in non-transfusion-dependent thalassemia (NTDT) patients: 1-year results from the THALASSA study. Blood. 2012;120(5):970–977. doi:10.1182/blood-2012-02-412692.
- Shah FT, Sayani F, Trompeter S, et al. Challenges of blood transfusions in β-thalassemia. Blood Rev. 2019;37:100588. doi:10.1016/j.blre.2019.100588.
- Saliba AN, El Rassi F, Taher AT. Clinical monitoring and management of complications of iron chelation therapy. Expert Rev Hematol. 2016;9(2):139–150. doi:10.1586/17474086.2016.1126510.
- British Society for Haematology (BSH). BSH Guideline on the Management of Iron Overload in Thalassaemia and Sickle Cell Disease. 2022.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023.
Editorial Team
This article was written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in hematology, transfusion medicine, and clinical pharmacology.
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