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Developed by Novartis and currently the only oral iron chelator, deferasirox was approved by the FDA in November 2005 for use in patients 2 years and older with chronic iron overload caused by blood transfusions. Deferasirox was approved by the European Commission in December 2012. Deferasirox is used for the treatment of chronic iron overload in patients aged 10 years and above with non-transfusion-dependent thalassemia (NTDT) syndrome who require chelation therapy due to contraindications or insufficiency of deferoxamine mesylate therapy. On January 23, 2013, the FDA approved a new indication for deferasirox. Deferasirox is used for the treatment of chronic iron overload in patients with non-transfusion-dependent thalassemia (NTDT) aged 10 years and above.

The recommended starting daily dose of deferasirox is 20 mg/kg. For patients who receive monthly transfusions of more than 14 mL/kg of packed red blood cells (i.e., more than 4 units/month for adults) and who need to reduce excess iron exposure, a starting dose of 30 mg/kg/day may be considered; for patients who receive less than 7 units per month Patients who require mL/kg packed red blood cell (i.e., less than 2 units/month in adults) transfusions and who need to maintain iron balance in the body may consider an initial dose of 10 mg/kg/day; patients who have already responded well to deferoxamine treatment may consider an initial dose of deferasirox equivalent to half the dose of deferoxamine. (For example, a patient receiving deferoxamine 40 mg/kg/day, 5 days a week or equivalent, may start with 20 mg/kg if switched to Enriga).

How to take Deferasirox: Deferasirox should be taken on an empty stomach at least 30 minutes before a meal, once a day, preferably at the same time every day. Do not chew the tablets or swallow them whole; do not take them with aluminum-containing antacids. The dosage (mg/kg) needs to be calculated and rounded to the nearest whole tablet; the tablets must be completely dissolved in water, apple juice or orange juice by stirring (10 0-200mL), drink it until a clear suspension is obtained. The remaining drug must be added with a small amount of water, apple juice or orange juice, mixed well and then taken. It is not recommended to dissolve in carbonated drinks or milk, because it will cause foam and delay the dispersion speed.