Exjade (deferasirox)
Also marketed as Jadenu and Jadenu Sprinkle. An approved treatment for Aceruloplasminemia.
The same compound appears under different names depending on the context. Here is how to identify Deferasirox wherever you encounter it, plus the key facts at a glance.
- Generic name
- Deferasirox
- Brand names
- Exjade, Jadenu, Jadenu Sprinkle
- Development code
- ICL670
- Drug class
- Iron chelator
- Manufacturer
- Novartis
- How it's taken
- Deferasirox is taken by mouth once a day.
A once-daily oral medicine (tablets or granules) that removes excess iron from the body. It is not FDA-approved for aceruloplasminemia, but doctors sometimes use it off-label to reduce the iron overload that accumulates when ceruloplasmin is absent.
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Where Deferasirox fits
A once-daily oral iron chelator that is FDA-approved for iron overload from blood transfusions and for iron overload in non-transfusion-dependent thalassemia. In aceruloplasminemia it is used off-label. Case reports show it lowers liver iron, but its effect on brain iron is unclear.
How Deferasirox works
Deferasirox grabs onto excess iron in your blood and binds to it. Once bound, the iron-drug combination is removed from your body mostly in your stool (feces). Very little leaves through the urine. Think of it as a chemical magnet that catches iron that's accumulating where it shouldn't be.
Mechanism: Oral iron chelator that binds excess iron for excretion
Side effects and safety
Common side effects include diarrhea, nausea, vomiting, stomach-area (abdominal) pain, skin rash, and a rise in a kidney blood test (serum creatinine). It may also cause dizziness. The FDA label has a boxed warning: deferasirox can cause kidney failure, liver failure, and bleeding in the stomach or intestines, which in some cases have been fatal. Regular blood and urine tests of kidney and liver function are required. Deferasirox can also lower blood cell counts (low white cells, low platelets, or worse anemia), which has sometimes been fatal, so blood counts are checked regularly. It can also cause serious allergic reactions and severe skin reactions that can be life-threatening. Get medical help right away for swelling of the face or throat, trouble breathing, blistering or peeling skin, or mouth sores. Hearing and vision problems are rare, so hearing and eye exams are advised before starting and every 12 months.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Deferasirox
Deferasirox is taken by mouth once a day. Jadenu tablets are swallowed with water, and Jadenu Sprinkle granules are sprinkled on soft food such as yogurt or applesauce. Both can be taken on an empty stomach or with a light meal. Exjade, the original form, is a tablet that must be fully stirred into water, orange juice, or apple juice and taken on an empty stomach at least 30 minutes before food. The dose is based on body weight and is adjusted using regular blood tests.
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Oral iron chelator available in generic form with multiple manufacturers. Essential supportive therapy for transfusion-dependent patients.
Help paying for Exjade
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Free medicine program
Covers Jadenu Sprinkle granules only: free to eligible patients who are uninsured or have government insurance and meet income limits.
For: no insurance, Medicare, Medicaid · source
Good to know: Deferasirox tablets are widely available as generics. Exjade and Jadenu no longer have their own brand support program. The foundation covers only Jadenu Sprinkle, not Exjade or Jadenu tablets.
Clinical trial results
Deferasirox was approved by the FDA in November 2005 for chronic iron overload in transfusion-dependent patients. In aceruloplasminemia, the evidence comes from case reports. They show it can lower iron in the liver, but it has not been shown to clear iron from the brain. Across iron chelators, nerve symptoms stayed stable or improved in some patients but got worse in others.
Development history
Developed by Novartis, deferasirox (Exjade) was approved on November 2, 2005 as a once-daily oral iron chelator. It gave iron-overloaded patients an alternative to deferoxamine, which is usually given as a slow infusion under the skin over 8 to 12 hours, 5 to 7 times a week. In 2013 it was also approved for iron overload in people with non-transfusion-dependent thalassemia. Newer formulations (Jadenu tablets in 2015, Jadenu Sprinkle granules in 2017) made it easier to take: they are swallowed or sprinkled on soft food and can be taken with a light meal, instead of being stirred into liquid on an empty stomach.
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Common questions about Deferasirox
▸What is Deferasirox (Exjade)?
A once-daily oral medicine (tablets or granules) that removes excess iron from the body. It is not FDA-approved for aceruloplasminemia, but doctors sometimes use it off-label to reduce the iron overload that accumulates when ceruloplasmin is absent.
▸How does Deferasirox work?
Deferasirox grabs onto excess iron in your blood and binds to it. Once bound, the iron-drug combination is removed from your body mostly in your stool (feces). Very little leaves through the urine. Think of it as a chemical magnet that catches iron that's accumulating where it shouldn't be.
▸What are the side effects of Deferasirox?
Common side effects include diarrhea, nausea, vomiting, stomach-area (abdominal) pain, skin rash, and a rise in a kidney blood test (serum creatinine). It may also cause dizziness. The FDA label has a boxed warning: deferasirox can cause kidney failure, liver failure, and bleeding in the stomach or intestines, which in some cases have been fatal. Regular blood and urine tests of kidney and liver function are required. Deferasirox can also lower blood cell counts (low white cells, low platelets, or worse anemia), which has sometimes been fatal, so blood counts are checked regularly. It can also cause serious allergic reactions and severe skin reactions that can be life-threatening. Get medical help right away for swelling of the face or throat, trouble breathing, blistering or peeling skin, or mouth sores. Hearing and vision problems are rare, so hearing and eye exams are advised before starting and every 12 months.
▸How is Deferasirox taken?
Deferasirox is taken by mouth once a day. Jadenu tablets are swallowed with water, and Jadenu Sprinkle granules are sprinkled on soft food such as yogurt or applesauce. Both can be taken on an empty stomach or with a light meal. Exjade, the original form, is a tablet that must be fully stirred into water, orange juice, or apple juice and taken on an empty stomach at least 30 minutes before food. The dose is based on body weight and is adjusted using regular blood tests.
▸Is Deferasirox FDA approved?
Yes, Deferasirox (Exjade) is FDA approved (2005) for the treatment of Aceruloplasminemia.
▸How does deferasirox help in aceruloplasminemia?
In aceruloplasminemia, iron accumulates in the brain, liver, and pancreas due to lack of functional ceruloplasmin. Deferasirox is an oral iron chelator that binds excess iron and removes it through the stool, helping reduce iron overload.
▸Is deferasirox specifically approved for aceruloplasminemia?
No. Deferasirox (Exjade, Jadenu) is FDA-approved only for chronic iron overload caused by blood transfusions in people 2 and older, and for chronic iron overload in people 10 and older with non-transfusion-dependent thalassemia. Using it for aceruloplasminemia is off-label and is based on published case reports.
▸How is deferasirox taken?
Deferasirox is taken orally once daily. The newer forms (Jadenu tablets and Jadenu Sprinkle granules) can be taken on an empty stomach or with a light meal, while the original Exjade tablets must be fully stirred into water, orange juice, or apple juice and taken on an empty stomach at least 30 minutes before food.
▸What monitoring is required?
Regular monitoring of kidney function, liver function, and serum ferritin (iron levels) is essential. Kidney and liver toxicity are known risks that require dose adjustments based on blood test results.
▸Is generic deferasirox available?
Yes, generic deferasirox is available, which can help reduce costs for long-term iron chelation therapy.
▸How does deferasirox compare to deferiprone for iron chelation?
Both are oral iron chelators, but they have different tissue distribution profiles. Deferiprone may cross the blood-brain barrier more effectively, which could be important for brain iron removal in aceruloplasminemia. Both carry boxed warnings: deferasirox for kidney, liver, and stomach or intestinal bleeding problems, and deferiprone for a severe drop in white blood cells (agranulocytosis) that can lead to serious infections. Your doctor can help weigh which fits you.