exjade

Exjade (deferasirox) binds to iron and removes it from the blood stream.

Exjade is used to treat iron overload caused by blood transfusions in adults and children at least 2 years old.

Exjade is also used to treat chronic iron overload syndrome caused by a genetic blood disorder in adults and children who are at least 10 years old.

Important information

You should not use Exjade if you have severe kidney or liver disease, advanced cancer, a blood cell or bone marrow disorder, or low levels of platelets in your blood.

Deferasirox can harm your liver or kidneys. Stop using Exjade and call your doctor at once if you have swelling, rapid weight gain, shortness of breath, pain in your upper stomach, loss of appetite, pain in your side or lower back, little or no urinating, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Deferasirox may also cause stomach or intestinal bleeding. Call your doctor at once if you have symptoms of stomach bleeding such as bloody or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

While you are taking Exjade, do not take antacids that contain aluminum, such as Amphojel, Gaviscon, Maalox, Mi-Acid, Mylanta, Rulox, and others.

Before taking this medicine

You should not use Exjade if you are allergic to deferasirox, or if you have:

• severe liver or kidney disease;

• advanced cancer;

• a bone marrow disorder; or

• low levels of platelets in your blood.

To make sure Exjade is safe for you, tell your doctor if you have:

• kidney disease;

• liver disease;

• anemia (low red blood cells);

• cancer (especially blood cell cancer such as leukemia);

• a stomach ulcer;

• a history of stomach or intestinal bleeding;

• vision or hearing problems; or

• a weak immune system caused by disease (such as cancer, HIV, or AIDS), or by receiving steroids, chemotherapy, or radiation.

It is not known whether Exjade will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Exjade can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

It is not known whether deferasirox passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking Exjade.

How should I take Exjade?

Take Exjade exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your doctor may perform certain tests to make sure you do not have conditions that would prevent you from safely using Exjade.

Take this medicine at the same time every day.

Take Exjade on an empty stomach at least 30 minutes before eating.

Do not chew, crush, or swallow the Exjade dispersible tablet whole. Place the tablet into a glass of apple juice, orange juice, or water and allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Drink this mixture right away. To make sure you get the entire dose, add a little more liquid to the same glass, swirl gently and drink right away.

If you take less than 1000 milligrams (1 gram) daily, dissolve the tablets in about one-half cup of apple juice, orange juice, or water. If you take more than 1000 milligrams daily, dissolve the tablets in about 1 cup of apple juice, orange juice, or water.

While using Exjade, you may need frequent blood tests. Your kidney or liver function may also need to be checked every 6 months, and you may need a liver biopsy.

Store at room temperature, away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Exjade?

Do not use other iron-chelating medicines such as deferoxamine (Desferal), unless your doctor has told you to.

While you are taking Exjade, do not take antacids that contain aluminum, such as Amphojel, Gaviscon, Maalox, Mi-Acid, Mylanta, Rulox, and others.

Exjade may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Exjade side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Exjade: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Exjade and call your doctor at once if you have:

• problems with vision or hearing;

• kidney problems - urinating more or less than usual; painful or difficult urination; swelling in your feet or ankles; weakness, bone pain; feeling tired or short of breath;

• liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• low blood cell counts - fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed; or

• severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Serious side effects may be more likely in older adults.

Common Exjade side effects may include:

• nausea, vomiting, stomach pain;

• diarrhea; or

• skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Exjade?

Many other medicines can increase or decrease the effects of Exjade. Tell your doctor about all your current medicines and any you start or stop using, especially:

• repaglinide, rifampin, ritonavir, theophylline;

• cholesterol-lowering medicine - cholestyramine, colestipol, colesevelam;

• a blood thinner - warfarin, Coumadin, Jantoven;

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• osteoporosis medicine - alendronate (Fosamax), risedronate (Actonel), and others;

• seizure medicine - carbamazepine, phenobarbital, phenytoin; or

• steroid medicine - prednisone, methylprednisolone, and others.

This list is not complete. Other drugs may interact with deferasirox, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.