地拉罗司要注意什么事项？

(Deferasirox) is currently the only oral iron chelator developed by Novartis. In November 2005, the US FDA approved Deferasirox for use in patients 2 years and older with chronic iron overload caused by blood transfusions. In December 2012, Deferasirox was approved by the European Commission for the treatment of chronic iron overload in patients aged 10 years and older 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 for the treatment of chronic iron overload in patients aged 10 years and older with non-transfusion-dependent thalassemia (NTDT).

The common starting dose of deferasirox is 20 mg/(kg·d). If there is a large amount of blood transfusion 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 disease.

What are the precautions for deferasirox?

Some gastrointestinal bleeding (including death) may occur while taking deferasirox; this is more common in patients with advanced hematological malignancies and/or elderly patients with low platelet counts; discontinue treatment for suspected gastrointestinal bleeding or ulceration. Nonfatal upper GI irritation, bleeding, and ulceration (sometimes complicated by GI perforation, including death) have been reported. Use concomitant medications with caution that may increase the risk of adverse gastrointestinal effects (eg, nonsteroidal anti-inflammatory drugs, corticosteroids, anticoagulants, oral bisphosphonates). Monitor patients closely for signs/symptoms of gastrointestinal ulceration/bleeding.

Although it can be used to treat thalassemia, it does not work in all people. You should not use this medicine if you have severe kidney or liver disease, advanced cancer, blood cell or bone marrow disorders, or low levels of platelets in your blood. If you continue to take this drug for treatment, it may lead to liver, kidney, and visceral failure.