2005年11月2日，诺华公司宣布，该公司铁螯合剂产品deferasirox（又名Exjade， ICL670，地拉罗斯）获得FDA批准上市。本品为首个1日一次的口服铁螯合剂产品，获准的适应证为2岁及以上儿童和成人患者由输血导致的慢性铁超负荷。

铁超负荷是一种渐进性的、可以危及生命的疾病，常常是频繁输血的不可避免的并发症。某些慢性血液疾病需要长期、频繁的输血，这些患者很可能发生铁超负荷，如海洋性贫血、镰刀细胞贫血、骨髓异常增生综合征等。铁超负荷的征象可能在10～20次输血后就可显现。如果不加治疗，体内过量的铁会损害肝脏、心脏和内分泌腺。

铁螯合剂是目前唯一有效的治疗输血相关铁过负荷的方法。

本品被认为是铁螯合治疗领域的重大突破。现有的标准治疗药物需要每周5－7次、每次8－12h皮下输注，并且只要患者继续接受输血或存在铁超负荷情况这样的治疗就将持续。给药的不便使很多患者放弃了治疗。而本品的给药就象喝果汁一样方便，服用前只须将片剂溶在水里或果汁里。

因此本品的出现极大地改善了铁螯合治疗的方便性，特别是对于儿童。
但近日美国FDA和诺华公司发出通告，更改铁鳌合剂deferasirox（Exjade）产品说明书的“警告”和“不良反应”部分。因该药上市后的监测显示，有些病人用该药后发生急性肾衰（有些是致死性的），大部分死亡病例有多种共存病，并处于血液病的晚期。
还有报告表明，用该药治疗的病人发生血细胞减少症，包括粒细胞缺乏症、中性粒细胞减少症和血小板减少症，一些病人死亡。这些事件与deferasirox治疗的关系尚不确定。
FDA告诫，对于并发症危险增加的病人（有肾功能障碍、年老、有共存病者，或正在用的药物有抑制肾功能者）应定期监测其血肌酐水平和血细胞计数。

EXJADE

Exjade Information

Exjade is a popular medicine that is able to bind to iron, thus removing it with high effectiveness from your blood stream.

Exjade Indications

Exjade is a well known medical product that is generally prescribed in the case of patients who are suffering from iron overload. This medical disorder is usually triggered by blood transfusions (it affects adults, but also children over 2 years of age). However, this medicine could serve some other medical purposes (like prevent or treat some other medical disorders) that have not been listed in this medicine guide. Ask your personal health care specialist for more information.

Exjade Warnings

Before you are allowed to start your treatment with Exjade, you should alert your personal health care specialist if you are suffering from liver or kidney disorders or from vision or hearing problems. Before you start taking this medicine you should inform your personal physician if you are suffering from allergic reactions to any foods, dyes or preservatives, if you are pregnant or breast feeding.

Exjade Intake Guidelines

Each patient who is starting a treatment with Exjade for the first time should ask his or her personal doctor how to properly take the doses of this medicine. Do not disobey any of your personal physician’s indications. If you fail to understand some of them, you should alert a nurse, a physician or a pharmacist. Ask them for further and more detailed explanations. In order to get more information regarding this medicine you should carefully read the drug’s leaflet. 

A dose of Exjade should be taken in 30 minutes before a main meal, on an empty stomach. Try to take your doses of this medicine at regular time intervals (if possible, at the same time each day, on a regular basis). You should avoid chewing, breaking or crushing your pills of Exjade (it is recommended to swallow the medicine as a whole).

Exjade Dosage

We strongly advise you to ask your personal doctor to calculate the dose of this medical product that should work best in your medical condition. The correct dosage of Exjade can vary from one patient to another, as it depends on a series of factors such as age, sex, severity of the condition, general health condition, etc. Do not deviate from the dosage of Exjade that you have been prescribed by your personal physician without his or her consent.

Exjade Overdose

If you start to suspect that you might be suffering from an overdose with Exjade, you are probably in need of immediate professional medical care. Alert your personal physician as soon as possible and contact your local poison control centre at once. You might even have to go to the nearest emergency room in order to receive a proper treatment. Although we have no detailed information regarding the possible side effects that could be triggered by an overdose with this medicine, a patient who has overdosed with Exjade will probably develop vomiting and nausea.

Exjade Missed Dose

In order to get the best results from your treatment with Exjade, it is very important that you do your best and try to take each and every one of your doses of this medicine regularly (if possible, at the same time each day). Follow the exact dosing schedule that you have been prescribed by your personal physician. If you miss one of your doses of this drug, contact your personal doctor as soon as you can and ask him or her for further instructions. Do not take double doses of this drug without first consulting it with an authorized healthcare provider, as this increases your risk of developing an unwanted overdose with Exjade.

Exjade Side Effects

Patients who start to experience any symptoms of signs of a severe allergic reaction to this medicine or any of its main ingredients (difficulty breathing; hives; swelling of your lips, tongue, face, or throat and so on) should stop using Exjade at once and should alert their personal health care specialist as soon as possible, as it is clear that they are in need of immediate medical attention. You should inform your personal physician as soon as you can if you develop any of these severe side effects (stop using Exjade):

• serious skin rash;
• problems with hearing or vision;
• less or no urine at all;
• abnormal bleeding and / or bruising, unusual weakness;
• body aches, fever, chills, flu like symptoms;
• confusion, drowsiness, loss of appetite, nausea, mood changes, vomiting;
• numbness and / or swelling in your feet or hands.

A treatment with Exjade could also trigger some other less severe but much more common side effects like the following:

• diarrhea, mild stomach discomfort or pain, vomiting and / or nausea;
• mild skin rash;
• fever;
• headache, sinus pain, cough, stuffy or runny nose.

Exjade Drug Reactions

Patients who are following a long term treatment with Exjade are not allowed to use any type of iron chelating drugs along with our medical product, as this could lead to sever drug interactions. During your intake of this medicine you should avoid taking antacids that are known to contain certain amounts of aluminum, such as Gaviscon, Amphojel, Maalox, Mylanta, Mi-Acid, Rulox, and so on.

Furthermore, while you are following a treatment with Exjade, you should avoid taking any other medicines without first consulting it with your personal physician (this includes over the counter prescriptions such as cold, cough drugs, herbal products, etc). Ask your physician for more information.

Buy Exjade

Buy Exjade through our Online Pharmacy Escrow Service or at any Canada Pharmacy where it is sold.

In some countries EXJADE may also be known as: DEFERASIROX