Jadenu (deferasirox) is a prescription drug typically used to treat chronic iron overload in patients. Deferasirox is an “active iron chelator” and belongs to the “chelating agent” drug class, which means this drug works to remove excess iron from the blood.
Deferasirox is sold under the brand name Jadenu. It is available as tablets and sprinkle granules.
Jadenu is for oral use only and is available upon a doctor’s prescription.
What Is Jadenu Used To Treat?
Jadenu is indicated to treat chronic iron overload caused by repeated blood transfusions in children 2 years of age and older.
It is also prescribed to thalassemic patients (adults and children age 10 and older) with chronic iron overload syndromes (the presence of a high amount of iron in the blood) caused by thalassemia. Thalassemia is a group of blood disorders that causes ineffective red blood cell production.
How Does Jadenu Work?
When a patient receives repeated blood transfusions for a prolonged period of time, the amount of iron in their blood increases significantly. Since our body does not have a natural way to remove this excess iron, the iron can accumulate causing damage to the organs, such as the heart or liver.
Jadenu, which is an active iron chelator, works to remove the excess iron from the blood. It binds to the iron molecules and is transported to the kidneys where it is removed from the body.
In short, this medication helps to prevent iron-induced organ damage in these patients.
Dosage Form and Strength
Jadenu is available in two formulations with the following dosage strengths:
- Tablets: 90 mg, 180 mg, 360 mg
- Sprinkle granules: 90 mg, 180 mg, 360 mg
What is the Usual Dosage?
Dosage for Adults and Children (2 years or older)
Adults and children undergoing blood transfusions should take 14 mg/kg once daily as their first dose. Adjustments can be made every 3 – 6 months based on serum ferritin levels.
Adult and Pediatric Dose for Thalassemia
The recommended dose for adults and children (10 years or older) with thalassemia is 7 mg/kg of Jadenu once daily. Monthly serum ferritin levels should be taken to assess a patient’s response to therapy. Patients should not exceed a maximum dose of 14 mg/kg/day.
What Happens If I Overdose?
An overdose can cause hepatitis and acute renal failure. Since there is no antidote for overdose, it is treated with induction of vomiting, gastric lavage, or symptomatic treatment.
It is important to carefully take your medication regularly as your doctor prescribes. If you missed your dose, skip it if it is almost time for your next dose. Do not take two doses at one time.
How Is Jadenu Administered?
Jadenu (tablet and sprinkle) is taken orally on an empty stomach or with a light meal (such as a small low-fat meal).
Administration of Tablets
You can take Jadenu tablets with water or other liquid once daily. Patients who have difficulty swallowing can crush the tablet and mix it with soft foods (e.g., yogurt or applesauce).
Swallow the soft food (with crushed tablet) without chewing it.
Administration of Jadenu Sprinkle
To take Jadenu sprinkle (granules), sprinkle the prescribed dose of medicine into a spoonful of soft food (e.g., yogurt or applesauce), and swallow it without chewing it.
Side Effects
Like any other medicine, Jadenu also has some common and potentially serious side effects.
Common Side Effects
The most common side effects (seen in greater than 5%) of patients with transfusional iron overload and thalassemia are as follows:
- Skin rashes
- Decreased kidney function
- Nausea
- Vomiting
- Stomach (abdominal) pain
- Diarrhea
Potentially Serious Side Effects
Jadenu also has some potentially serious and life-threatening side effects, which include:
- Acute kidney injury, including acute renal failure requiring dialysis and renal tubular toxicity, including Fanconi syndrome
- Hepatic (liver) toxicity, including failure
- Gastrointestinal hemorrhage (bleeding)
- Severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS)
- Low blood cell counts due to bone marrow suppression
- Skin rash
- Auditory (hearing) or ocular (vision) problems
If you experience any side effects mentioned above, immediately consult your healthcare provider.
What Precautions Should You Take While Taking Jadenu?
Before taking Jadenu, it is important to consult your healthcare provider and share your current health status and medical history. Tell your doctor if you are:
- Pregnant or intending to become pregnant: It is not known whether Jadenu can cause fetal harm or not. Therefore, it is important to consult your healthcare provider before taking Jadenu.
- Breastfeeding: It is unclear whether Jadenu passes to breastmilk; therefore, you should avoid taking Jadenu if you are breastfeeding.
- Taking prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.
If you have the following medical conditions, you should not take Jadenu:
- Severe liver or kidney problems
- Low level of platelets
- Advanced cancer (such as leukemia)
- Bone marrow disorder
- Stomach ulcer
- Anemia (low red blood cells)
- AIDS or HIV
What Other Medications Should You Avoid While Taking Jadenu?
You should avoid taking other iron-chelating medications, such as Desferal (deferoxamine), while taking Jadenu.
Similarly, do not take aluminum-containing antacids (medicines used to treat heartburn). Though Jadenu has a lower affinity for aluminum than iron, it can affect its working mechanism.
Other medications that should be avoided include:
- Theophylline
- Bile acid sequestrants (medicines to lower cholesterol)
Cost
The cost of Jadenu tablets can be notably high for some patients and vary based on their strength or insurance coverage. For example, the price for Jadenu oral tablets (90 mg) is around $1,595 for a supply of 30 tablets. On the other hand, the cost of Jadenu oral tablets (180 mg) is around $3,180.51, and the cost of Jadenu oral tablets (360 mg) is around $6,351.42 for a supply of 30 tablets.
If you’re considering taking Jadenu, contact us about potential assistance programs that can help reduce out-of-pocket expenses.
REFERENCES:
- US Food and Drug Administration (FDA). Jadenu (Deferasirox) Prescribing Information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/207968s000lbl.pdf
- FDA approves new oral formulation of deferasirox (Jadenu) for chronic iron overload. (2015). Oncology Times, 37(8), 10. https://doi.org/10.1097/01.cot.0000465181.52219.0a
- Yassin, M. A., Soliman, A. T., Sanctis, V. D., Hussein, R. M., Al-Okka, R., Kassem, N., Ghasoub, R., Basha, A., Nashwan, A. J., & Adel, A. M. (2018). Jadenu® Substituting Exjade® in Iron Overloaded β-Thalassemia Major (BTM) Patients: A Preliminary Report of the Effects on the Tolerability, Serum Ferritin Level, Liver Iron Concentration and Biochemical Profiles. Mediterranean Journal of Hematology and Infectious Diseases, 10(1). https://doi.org/10.4084/MJHID.2018.064
- Tinsley, S. M., & Hoehner-Cooper, C. M. (2018). Transitioning patients with iron overload from Exjade to Jadenu. Journal of Infusion Nursing, 41(3), 171–175. https://doi.org/10.1097/nan.0000000000000278
- Deferasirox: MedlinePlus drug information. (n.d.). https://medlineplus.gov/druginfo/meds/a606002.html
