Medicines

Deferasirox for removing excess iron

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Contents of this leaflet

Name of medicine

Deferasirox (dee-FER-a-sir-ox)

Brand name: Exjade®

This leaflet is about the use of deferasirox for removing excess (too much) iron in the body.

Why is it important for my child to take deferasirox?

Your child may have too much iron in their body and blood. This can be caused by having many blood transfusions or have certain types of anaemia (low red blood cells). The excess iron can damage some body organs, such as the liver and heart. Deferasirox removes the excess iron from your child’s body so that levels of iron return to normal. This reduces the chance of any damage to your child’s organs.

What is deferasirox available as?

Dispersible tablets: 125 mg, 250 mg, 500 mg; these contain small amounts of lactose

When should I give deferasirox

Deferasirox is usually given once each day. This is usually in the morning.

This medicine needs to be taken on an empty stomach. Wait at least 30 minutes after giving it before your child has any food.

Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of deferasirox (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor may change the dose, depending on how your child responds to the medicine.

It is important that you follow your doctor’s instructions about how much to give.

How should I give deferasirox?

Tablets

Dissolve the tablet(s) in a small glass of water or fruit juice (100 to 200 ml). Stir the liquid until the tablet(s) dissolve completely. The mixture will look cloudy. Your child should drink it all straight away. Then add some more water or juice to the glass, swirl it round and ask your child to drink it. This makes sure they get all the medicine.

  • Your child should not chew the tablets or swallow them whole.
  • Do not break or crush the tablets.
  • Do not dissolve the tablets(s) in fizzy drinks or milk.

When should the medicine start working?

The medicine should start working straight away, although you will not see any difference in your child.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of deferasirox, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of deferasirox, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due. Give the next dose as usual.

Never give a double dose of deferasirox.

What if I give too much?

If you are concerned that you may have given too much, contact your doctor or local NHS services (call 111 in England and Scotland; 111 or 0845 4647 in parts of Wales) or take your child to hospital. Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.

It can be dangerous to give too much deferasirox.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).

Side effects you must do something about

If your child is short of breath or is wheezing, or their face, lips or tongue start to swell, or they develop a rash, they may be allergic to deferasirox. Take your child to hospital or phone for an ambulance straight away.

If your child starts being sick every few hours, has stomach pains, is very sleepy or has jaundice (the skin or eyes look yellow), take them to your doctor or hospital straight away, as there may be a problem with your child’s liver.

If there is a sudden reduction in your child’s ability to pass urine (wee), or your baby has fewer wet nappies, contact your doctor as there may be a problem with your child’s kidneys.

Other side-effects you need to know about

If your child has any of these side-effects contact your doctor:

  • problems with their eyesight, such as blurry or cloudy vision
  • they cannot hear clearly
  • they vomit blood and/or have black stools (poo).

  • Your child may get a headache or a skin rash, or may have nausea (feel sick), vomiting, diarrhoea, stomach pain, bloating, constipation or indigestion (heartburn). These symptoms are usually mild and wear off after a few days as your child gets used to the medicine. If they are still a problem after 2 weeks, or if you are worried, contact your doctor, but continue to give deferasirox.

  • If your child gets stomach pains more often, especially after eating or taking deferasirox, contact your doctor.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

More information on side-effects can be found in a leaflet on our website.

Can other medicines be given at the same time as deferasirox?

  • You can give your child medicines that contain paracetamol, unless your doctor has told you not to. 
  • If your child needs to take any medicines for indigestion (antacids), do not give these with deferasirox. Give the two medicines at different times of the day.
  • Deferasirox should not be taken with some medicines that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before giving deferasirox.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Do not give your child medicines that contain ibuprofen as there is some risk it will cause stomach bleeding.

Is there anything else I need to know about this medicine?

  • Do not give your child any medicine or preparation that contains vitamin C, such as multivitamins, when giving deferasirox, because large quantities of vitamin C increase the absorption of iron.
  • Your doctor will need to check your child’s hearing and eyesight before they start taking deferasirox and once a year after that. Your doctor will also test your child’s blood and urine (wee) regularly to check that deferasirox has not affected their liver or kidneys. It is important to keep all of your appointments.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • If you feel your child is not improving, do not give extra medicine. Please continue with the regular dose and speak to your doctor.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Where should I keep this medicine?

  • Keep this medicine in a cupboard, away from heat, direct sunlight and excess moisture (do not keep it in the bathroom).
  • It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in, in order to protect it from moisture

Who to contact for more information?

Your doctor, pharmacist or nurse will be able to give you more information about deferasirox and about other medicines used to treat excess iron.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS 111 Wales

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by April 2020.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.