地拉罗司使用量是多少？

How much is used?

The common starting dose of deferasirox is 20 mg/(kg·d);

If massive blood transfusion occurs and the iron increase is >0.5 mg/(kg·d) or the iron load before treatment is high, the recommended dose is 30 mg/(kg·d). If the iron increase is <0.3 mg/kg, 10-15 mg/kg/d is sufficient to control the condition.

Administer on an empty stomach 30 minutes before meals and should be completely dissolved in water or apple or orange juice.

Lower doses of deferasirox [5-10 mg/(kg·d)] can only be used in young patients with mild iron overload and few blood transfusions, or in elderly patients who have not received satisfactory results from chelation therapy in the past.

Patients taking deferasole 20 and 30 mg/(kg·d) need to carefully monitor body iron stores, as 50% and 10% of patients may still have persistently elevated body iron levels. In addition, the frequency of blood transfusion can also affect the effect of deferasirox in controlling liver concentrations. When the iron intake is greater than 0.5 mg/(kg·d), only 47% of patients who receive the same dose of deferasirox achieve a reduction in liver concentrations.

Overdose of deferasirox:

1. Cases of overdose (taking 2-3 times the prescribed dose for several weeks) have been reported. One case report reported that an overdose resulted in subclinical hepatitis, which resolved after discontinuation of the drug, with no long-term effects.

2. Thalassemia patients with iron overload can tolerate a single dose of 80 mg/kg with only mild nausea and diarrhea.

3. A single dose of 40mg/kg can be well tolerated by healthy volunteers.

4. Signs of acute overdose include nausea, vomiting, headache and diarrhea. Treatment of overdose includes induction of vomiting, gastric lavage, and symptomatic treatment.

Deferasirox drug interactions:

1. Avoid combination with strong inducers of UDP-glucuronosyltransferase (UGT) (such as rifampicin, phenytoin, sedatives and hypnotics, protease inhibitors) and cholestyramine.

2. It cannot be administered at the same time as aluminum-containing antacids. Not to be combined with other iron chelation treatments.

3. Be careful with repaglinide, drugs with potential ulcerogenic effects such as NSAIDs, cortisones, or oral bisphosphonates, drugs metabolized by CYP3A4 (such as cyclosporine, simvastatin, hormonal contraceptives). Pause at least 5 days before performing Gallium-67 imaging.