Iron chelating agents
ATC code: V03AC03 (Deferasirox)
Brand names
Deferasirox Stada, Exjade, Jadenu, Deferasirox Mylan
Oral selective iron chelator. Forms a "2 deferasirox molecules – 1 Fe3+ ion" complex excreted in feces via bile. Unlike parenteral deferoxamine, deferasirox is orally active – convenient for patients with lifelong transfusion dependence. Half-life 8-16 hours allows once-daily dosing.
First line
First-line iron-overload therapy in transfusion-dependent anemias (beta-thalassemia major, sickle cell disease, lower-risk MDS) per TIF 2023 and Spanish SEHH 2022. Starting dose 14 mg/kg once daily on empty stomach 30 minutes before food (Jadenu/film-coated tablets), or 20 mg/kg for the original Exjade form (dispersible tablets). Target – ferritin <1000 ng/mL, LIC (T2* MRI liver iron concentration) <7 mg/g dry weight.
Sources
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Deferasirox is an oral iron chelator. It is prescribed for confirmed iron overload associated with chronic blood transfusions (thalassemia, sickle cell anemia, myelodysplastic syndrome) and hereditary hemochromatosis (AEMPS Ficha Técnica). In alt detox circles, deferasirox is occasionally promoted to remove heavy metals or for iron overload in healthy people without confirmed hyperferritinemia. In healthy adults, no clinical studies of such use exist, and use is dangerous. The drug has serious risks: acute kidney injury, hepatotoxicity up to acute liver failure ( boxed warning), gastrointestinal bleeding, and myelosuppression. If deferasirox was prescribed for detox without confirmed iron overload, seek a second opinion immediately.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Direct links to regulator labels. Open in a new tab.
Boxed warning
FDA boxed warning 2010: risk of acute kidney injury, hepatic failure, and GI hemorrhage. Particularly in older patients with advanced MDS and multiple comorbidities.
No human pregnancy data. Barrier contraception recommended in women of reproductive age – deferasirox may reduce hormonal contraceptive efficacy via CYP3A4 induction.
No milk excretion data. Discontinue breastfeeding during therapy.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Deferasirox is evaluated for the following indications with varying evidence strength: Iron overload in thalassemia (evidence tier A), Body detoxification and cleansing (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Deferasirox (≥ 1 in 100): Nausea, Diarrhea, Rash, Creatinine elevation (20-30% of patients), ALT/AST elevation, Abdominal pain. See the Safety section for uncommon and serious reactions.
FDA category C. No human pregnancy data. Barrier contraception recommended in women of reproductive age – deferasirox may reduce hormonal contraceptive efficacy via CYP3A4 induction.
No milk excretion data. Discontinue breastfeeding during therapy.
Deferasirox is contraindicated in: Hypersensitivity; Severe renal impairment (eGFR <40 mL/min/1.73m²); Platelets <50×10⁹/L in MDS; Severe hepatic impairment Child-Pugh C. Full list in the Safety section.
FDA boxed warning 2010: risk of acute kidney injury, hepatic failure, and GI hemorrhage. Particularly in older patients with advanced MDS and multiple comorbidities.