Deferasirox, Oral de-FER-a-sir-ox

What are other names for this medicine?

Type of medicine: chelating agent; antidote for iron poisoning

Generic and brand names: deferasirox, oral; Exjade

What is this medicine used for?

This medicine is taken by mouth to treat excess iron in the body from blood transfusions. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding problems or a blood disorder such as anemia or sickle cell disease
• eye problems such as cataracts and glaucoma
• hearing problems
• kidney or liver disease

Females of childbearing age: Tell your healthcare provider if you are pregnant or if you plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take the medicine exactly as prescribed by your healthcare provider. Do not take more or less or take it longer time than prescribed. Do not stop taking this medicine without your healthcare provider's approval.

Take the medicine at the same time each day on an empty stomach at least 30 minutes before eating any food. Take this medicine 2 hours before or 3 hours after taking an antacid that contains aluminum.

Dissolve the tablets completely in water, orange juice, or apple juice. Drink the mixture immediately. After drinking the mixture, add a small amount of liquid to the glass, swirl it around, and drink that too. Do not chew the tablets. Do not take the tablets without dissolving them.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, diarrhea, yellowing of eyes or skin, severe stomach pain.

What should I watch out for?

This medicine may cause serious or life-threatening side effects, such as kidney or liver problems, or bleeding in the stomach or intestines. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments. Talk with your healthcare provider about this.

You will need to have regular hearing tests and eye exams while taking this medicine. If you notice changes in your vision or hearing, contact your healthcare provider.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are receiving this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Rash, severe stomach pain, fever, headache, trouble hearing or seeing, coughing blood, vomiting blood, black or tarry stools, severe leg cramps, trouble urinating or decreased urination, yellowing of the skin or eyes, unusual bleeding or bruising, unusual tiredness or weakness, sore throat.

Other: Dizziness, diarrhea, nausea, vomiting, itching, stomach pain, muscle aches and pains, tiredness, stuffy nose.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antacids that contain aluminum (Take them 2 to 3 hours before or after you take this medicine.)
• antidepressants such as fluvoxamine (Luvox CR), imipramine (Tofranil),
• asthma medicines such as theophylline and zileuton (Zyflo)
• cholesterol-lowering medicines such as atorvastatin (Lipitor), cholestyramine (Questran), and simvastatin (Zocor)
• corticosteroids such as betamethasone (Celestone), cortisone, dexamethasone, fludrocortisone (Florinef), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisolone (Orapred), prednisone, and triamcinolone (Aristospan, Kenalog)
• deferoxamine (Desferal)
• diabetes medicines such as pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• haloperidol (Haldol)
• hormonal birth control such as pills, implants, shots, patches, or vaginal rings
• immunosuppressants such as cyclosporine (Neoral, Sandimmune) and tacrolimus (Prograf)
• medicine to treat or prevent blood clots such as warfarin (Coumadin), heparin, enoxaparin (Lovenox), and dalteparin (Fragmin)
• medicines to treat bone loss such as alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel)
• mexiletine
• muscle relaxants such as cyclobenzaprine (Flexeril) and tizanidine (Zanaflex)
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• olanzapine (Zyprexa)
• paclitaxel (Onxol)
• phenobarbital
• phenytoin (Dilantin)
• rifampin (Rifadin)
• ritonavir (Norvir)
• zolmitriptan (Zomig)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, moisture, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.