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(deferasirox) is an oral iron chelator that was approved by the FDA in 2005 for the treatment of chronic iron overload caused by blood transfusions. The original developer was Novartis Pharmaceuticals. In January 2013, the FDA approved expanded indications to treat chronic iron overdose caused by Non-Transfusion Dependent Thalassemia Syndromes (NTDT), making Exjade the first drug to treat this indication. NTDT is a mild form of thalassemia that does not require frequent blood transfusions. However, even if patients do not receive blood transfusions, they will accumulate excess iron and damage various tissues and organs. Currently, deferasirox has been approved in more than 100 countries around the world for the treatment of transfusion-induced iron overload in children over 2 years old.

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 in adults) and who need to reduce excess iron exposure, a starting dose of 30 mg/kg/day may be considered. For patients who receive monthly transfusions of less than 7 mL/kg of packed red blood cells (i.e., less than 2 units/month in adults) and who need to maintain body iron balance, a starting dose of 10 mg/kg/day may be considered.

In patients who have already responded well to deferoxamine therapy, an initial dose of Enriga equivalent to half the deferoxamine dose may be considered. (For example, a patient receiving deferoxamine 40 mg/kg/day, 5 days per week, or equivalent, may start at 20 mg/kg if switched to Enriga.)

Deferasirox dispersible tablets should be taken once daily on an empty stomach, at least 30 minutes before a meal, preferably at the same time each day. Tablets should not be chewed or swallowed whole. Deferasirox dispersible tablets should not be taken together with aluminum-containing antacids, and the dosage (mg/kg) needs to be calculated and rounded to the nearest whole tablet. Completely dissolve the tablets in water, apple juice or orange juice (100-200mL) by stirring until a clear suspension is obtained and then drink it. The remaining medicine must be added with a small amount of water, apple juice or orange juice and mixed well before being taken. Not recommended for dissolution in carbonated drinks or milk as it can cause foaming and slow dispersion.

At the same time, in order to ensure that the efficacy of (deferasirox) is better exerted, combination with strong inducers of UDP-glucuronosyltransferase (UGT) (such as rifampicin, phenytoin, sedatives and hypnotics, protease inhibitors) and cholestyramine should be avoided. Do not administer concurrently with aluminum-containing antacids. Not to be combined with other iron chelation treatments. 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). Withhold deferasirox at least 5 days before performing gallium-67 imaging.

Common adverse reactions of deferasirox include: diarrhea, vomiting, headache, abdominal pain, fever, rash, increased serum creatinine (Creatinine), etc. Other adverse reactions include: increased liver enzymes, cough, throat inflammation, and urticaria.