Deferasirox is an oral iron chelator primarily used to treat chronic iron overload, such as hemosiderosis caused by blood transfusions. The indications are clear, and medication must strictly follow dosage adjustment and monitoring requirements, while paying attention to potential risks such as liver and kidney function damage, gastrointestinal reactions, etc.

1. Indications

(1) Transfusion induced iron overload: suitable for patients aged 2 years and above with chronic iron overload caused by blood transfusion, such as thalassemia, myelodysplastic syndrome, etc.

(2) Non transfusion iron overload: suitable for the treatment of chronic iron overload in non transfusion dependent thalassemia patients aged 10 years and above.

2. Medication precautions

(1) Liver function monitoring: ALT, AST, and bilirubin should be regularly monitored before and during treatment. Medication should be suspended when liver enzymes increase by more than 5 times ULN.

(2) Renal function monitoring: may lead to elevated creatinine levels. Renal function should be monitored weekly before and during treatment. If eGFR continues to decrease, dosage adjustment or discontinuation of medication is necessary.

(3) Gastrointestinal reactions: common nausea, vomiting, and abdominal pain. It is recommended to take it with meals to alleviate symptoms, and in severe cases, symptomatic treatment is necessary.

(4) Hematological monitoring: may cause neutropenia or thrombocytopenia, and regular blood routine checks are necessary.

(5) Allergic reactions: The incidence of rash is about 10%, and severe allergies require immediate discontinuation of medication and medical attention.

3. Medication for special populations

(1) Children: Safety has not been established for children under 2 years old, and dosage should be adjusted according to weight for children aged 2-10 years old.

(2) Pregnant women: Use only when the benefits outweigh the risks, animal experiments have shown embryotoxicity.

(3) Breastfeeding period: Medication can be secreted into breast milk. It is recommended to discontinue medication or breastfeeding.

(4) Elderly people: Use medication with caution as liver and kidney function may decrease.