Deferasirox

Pronunciation: de-fer-AS-i-rox.

Generic name
deferasirox
Drug class
Iron chelator
Form
Film-coated tablet (Jadenu: 90 mg, 180 mg, 360 mg) or dispersible tablet for oral suspension (Exjade: 125 mg, 250 mg, 500 mg)
Route
Oral
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Jadenu (6), Exjade (6) · Full directory

What deferasirox is and how it works

Deferasirox is an oral iron-chelating medicine used to remove excess iron from the body in people who have chronic iron overload, most often from repeated blood transfusions (for conditions like thalassaemia, sickle cell disease, or other chronic anaemias), and in some people with non-transfusion-dependent thalassaemia who have too much iron in the liver. (1) (4)

Deferasirox binds to excess iron in the blood so it can be removed from the body, mainly through the stool. It carries a genuine, serious boxed warning for kidney failure, liver failure, and stomach/gut bleeding, so treatment requires regular blood and urine tests and close supervision by a clinician experienced in iron-overload management.

Mechanism of action: how deferasirox works

Deferasirox is an orally active, highly selective iron (III) chelator that binds iron in a 2:1 ratio, forming a complex that is excreted primarily in the faeces, reducing total body iron burden. (1) (6)

What deferasirox is used for

Chronic iron overload from blood transfusions

Used to treat chronic iron overload caused by frequent blood transfusions, in patients 2 years of age and older (Jadenu) or 6 years and older (Exjade, per UK/EU/Australia labelling). (1) (3)

Non-transfusion-dependent thalassaemia (NTDT)

Used to treat chronic iron overload in patients with non-transfusion-dependent thalassaemia syndromes, aged 10 years and older, who meet specific liver iron concentration and serum ferritin criteria. (1)

Before taking deferasirox

Do not take / not appropriate for

  • Do not take deferasirox if your estimated glomerular filtration rate (eGFR) is below 40 mL/min/1.73 m2. (all countries where authorised) (1)
  • Do not take deferasirox if you have poor overall performance status, high-risk myelodysplastic syndromes, advanced cancers, or a platelet count below 50 x 10^9/L, unless your specialist has specifically advised otherwise. (United States) (1)
  • Do not take deferasirox if you have had a serious allergic reaction to it. (all countries where authorised) (1)

Tell your clinician about

  • Any kidney problems or reduced kidney function.
  • Any liver problems.
  • Any history of stomach ulcers, gastrointestinal bleeding, or low platelet count.
  • Any hearing or vision problems.
  • Whether you are dehydrated, since this raises kidney risk.
  • All other medicines, especially other medicines that can affect the kidneys.
  • Whether you are pregnant, planning pregnancy, or breastfeeding.
  • Whether you are taking Exjade or Jadenu specifically, since the doses are different and not directly interchangeable.
(1) (7)

How to take deferasirox

  • Jadenu tablets/granules are usually taken once daily on an empty stomach or with a light meal, at the same time each day.
  • Exjade dispersible tablets are dissolved in water, orange juice, or apple juice and taken once daily on an empty stomach, at least 30 minutes before food.
  • Do not switch between Exjade and Jadenu, or change your dose, without your prescriber's specific instructions, since the two formulations require different doses.
  • Your dose will be individualised and adjusted by your clinician based on regular ferritin, kidney, and liver monitoring -- do not adjust your own dose.
(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

Contact your prescriber or care team for guidance if you miss a dose, since deferasirox dosing and monitoring are individualised and timing can matter for both effectiveness and safety.

Overdose

Seek urgent medical attention if you think you have taken too much deferasirox, or if you notice signs of kidney problems (little or no urination, swelling), liver problems (yellowing skin/eyes, dark urine, severe tiredness), or gastrointestinal bleeding (black or bloody stools, vomiting blood). (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Nausea, vomiting, diarrhoea, or abdominal pain.

What to notice: Nausea, vomiting, diarrhoea, or abdominal pain.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Skin rash.

What to notice: Skin rash.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Headache.

What to notice: Headache.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Increase in blood creatinine (a marker of kidney function).

What to notice: Increase in blood creatinine (a marker of kidney function).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of kidney failure — emergency

Symptoms: Little or no urination, swelling in the legs/ankles/feet, unusual tiredness, or confusion.

Action: Seek emergency medical help immediately -- deferasirox carries a genuine FDA boxed warning for acute renal failure and death, particularly in people with other serious health conditions. Regular kidney function monitoring is required throughout treatment. (1) (2) (3)

Signs of liver failure — emergency

Symptoms: Yellowing of the skin or eyes (jaundice), dark urine, severe tiredness, loss of appetite, nausea, right-upper abdominal pain, or confusion.

Action: Seek emergency medical help immediately -- deferasirox carries a genuine FDA boxed warning for hepatic injury including failure and death, which can include hyperammonaemic encephalopathy (confusion caused by high ammonia levels). Regular liver function monitoring is required throughout treatment. (1) (3)

Signs of gastrointestinal bleeding or ulceration — emergency

Symptoms: Black or tarry stools, vomiting blood or material that looks like coffee grounds, or severe stomach pain.

Action: Seek emergency medical help immediately -- deferasirox carries a genuine FDA boxed warning for GI haemorrhage, which may be fatal, especially in elderly patients and those with blood cancers or low platelet counts. (1) (3)

Signs of low blood counts — high caution

Symptoms: Unusual bruising or bleeding, fever, sore throat, or signs of infection.

Action: Contact your clinician promptly -- bone marrow suppression (including neutropenia, agranulocytosis, and worsening of existing blood count problems) has been reported. (1)

Serious skin reaction — emergency

Symptoms: Widespread rash, blistering, or peeling skin, especially with fever or mouth sores.

Action: Seek emergency medical help immediately -- severe skin reactions have been reported. (1)

Interactions

  • Other medicines that can affect the kidneys (nephrotoxic drugs) can increase the risk of kidney injury when combined with deferasirox. (1)
  • Aluminium-containing antacids should not be taken at the same time as deferasirox. (3)
  • Certain other medicines can change deferasirox blood levels (for example, some antivirals, hormonal contraceptives, and enzyme-inducing medicines) -- tell your clinician about all medicines you take. (3)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Limited data; use only if the potential benefit justifies the potential risk, and discuss with your prescriber. (1) (2) (3) (4) (5) (6) (7)

Breastfeeding

Not recommended, since it is not known whether deferasirox passes into breast milk. (1) (2) (3) (4) (5) (6) (7)

Children

Jadenu is approved from age 2 years and older (transfusional overload); Exjade from age 6 years and older in some markets, with a lower age limit in others -- children require careful weight-based dosing and monitoring, with renal tubulopathy specifically reported more often in children and adolescents. (1) (2) (3) (4) (5) (6) (7)

Elderly

Higher risk of serious adverse reactions, including fatal ones, particularly GI haemorrhage and renal/hepatic events -- closer monitoring recommended. (1) (2) (3) (4) (5) (6) (7)

Hepatic_impairment

Not recommended in patients with severe hepatic impairment (Child-Pugh C); dose reduction and close monitoring needed in moderate impairment. (1) (2) (3) (4) (5) (6) (7)

Renal_impairment

Contraindicated if eGFR is below 40 mL/min/1.73 m2 (US label); dose reduction, more frequent monitoring, or discontinuation required if renal function declines during treatment. (1) (2) (3) (4) (5) (6) (7)

Monitoring

Before starting

  • Serum creatinine / eGFR (on two occasions)
  • Liver function tests
  • Complete blood count
  • Serum ferritin
  • Urine protein

During treatment

  • Monthly serum creatinine/renal function and liver function tests.
  • Monthly serum ferritin to guide dose adjustment (typically reviewed every 3-6 months for dose changes).
  • Regular complete blood counts.
  • Annual (or as clinically indicated) hearing and eye examinations.
  • Prompt evaluation of any signs of GI bleeding, kidney problems, or liver problems.
(1)

Storage

Store at room temperature, in the original packaging, protected from moisture, and out of the reach of children.

Professional information

Clinician-facing context only, sourced from the current US prescribing information and UK SmPC; verify against the current full label before prescribing.

United States, United Kingdom, European Union, Canada, Australia, New Zealand

Indication: Chronic iron overload from blood transfusions; NTDT with specific liver-iron/ferritin criteria

Dose summary: Individualised, weight-based dosing; Jadenu requires approximately 30% lower dose than the equivalent Exjade dose due to higher bioavailability. Dose titrated against serum ferritin trend every 3-6 months, using the minimum effective dose. Baseline and monthly monitoring of renal function, liver function, and blood counts required.

Renal context: Contraindicated if eGFR <40 mL/min/1.73 m2 (US); dose reduction/discontinuation required for renal function decline during treatment; renal tubulopathy reported more often in children. (1)

Mechanism of action

Hepatic guidance

Not recommended in severe hepatic impairment (Child-Pugh C); dose reduction in moderate impairment.

Overdose note

Manage with supportive care and close monitoring of renal and hepatic function and for GI bleeding; no specific antidote is described in the sources reviewed. (1) (6)

Frequently asked questions

Does deferasirox (Exjade/Jadenu) really have a boxed warning?

Yes. A direct check of the current US prescribing information for both Jadenu and Exjade confirms a genuine FDA boxed warning with three parts: it can cause acute kidney failure and death, it can cause liver injury including failure and death, and it can cause gastrointestinal bleeding which may be fatal, especially in older adults. This is why regular blood and kidney/liver monitoring is required throughout treatment, and why it is only prescribed and monitored by clinicians experienced in managing iron overload. (1) (2) (3)

What is the difference between Exjade and Jadenu?

Both contain the same active ingredient, deferasirox, but they are different formulations. Exjade is an older dispersible tablet that is dissolved in liquid and taken on an empty stomach. Jadenu is a newer film-coated tablet (or granule) that can be taken with a light meal, is generally better tolerated, and requires a lower dose (roughly 30% less) than the equivalent Exjade dose because it is absorbed more efficiently. They are not interchangeable milligram-for-milligram -- any switch between them should only be done by your prescriber. (1) (5)

Who should not take deferasirox?

Deferasirox should not be used if your kidney function is significantly reduced (eGFR below 40 mL/min/1.73m2), if you have poor overall performance status, high-risk myelodysplastic syndromes, advanced cancer, a platelet count below 50 x 10^9/L, or a known hypersensitivity to deferasirox. Your prescriber will check your kidney function, liver function, and blood counts before starting and regularly during treatment. (1)

What is the mechanism of action of deferasirox?

Deferasirox is an orally active, highly selective iron (III) chelator that binds iron in a 2:1 ratio, forming a complex that is excreted primarily in the faeces, reducing total body iron burden. (1) (6)

What is the generic name of Deferasirox?

The generic name is deferasirox. (1) (2)

What class of drug is deferasirox?

Deferasirox is classed as: Iron chelator. (1) (2)

References

  1. JADENU (deferasirox) tablets, film coated / JADENU (deferasirox) granule -- full prescribing information (Revised 7/2020, label current as of live fetch 2026-07-30)U.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Novartis Pharmaceuticals Corporation · United States · accessed 2026-07-30 · source 1
  2. EXJADE (deferasirox) tablets, for oral suspension -- full prescribing information (Revised 7/2020, DailyMed page updated 2026-01-28, current/active)U.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Novartis Pharmaceuticals Corporation · United States · accessed 2026-07-30 · source 2
  3. Exjade 90 mg / 180 mg / 360 mg film-coated tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Novartis Pharmaceuticals UK Ltd · United Kingdom · accessed 2026-07-30 · source 3
  4. Exjade (deferasirox) -- EPAR medicine overview; Deferasirox Accord / Deferasirox Mylan -- generic EPARsEuropean Medicines Agency (EMA) -- EPAR for Exjade, plus generic Deferasirox Accord/Mylan EPARs · European Union · accessed 2026-07-30 · source 4
  5. EXJADE (deferasirox) dispersible tablets and JADENU (deferasirox) film-coated tablets -- Product MonographsHealth Canada product monographs, Novartis Pharmaceuticals Canada Inc. · Canada · accessed 2026-07-30 · source 5
  6. JADENU deferasirox 90 mg / 180 mg / 360 mg film-coated tablet -- ARTG entries 286751 / 286761 / 293497; EXJADE (deferasirox) -- TGA-registered 2006Therapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 6
  7. EXJADE (deferasirox) -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 7

Brand names by country

Single-ingredient deferasirox names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Jadenu180 mg, 360 mg, 90 mg · novartis pharmaceuticals corporation
  • Exjade125 mg, 250 mg, 500 mg · novartis pharmaceuticals corporation
  • Deferasorox360 mg, 90 mg, 180 mg · novadoz pharmaceuticals llc

United Kingdom

  • Exjade (3)MHRA licensed emc smpc confirmed · 90 mg, 180 mg, 360 mg · Novartis Pharmaceuticals UK Ltd

Canada

  • EXJADE
  • JADENU

Australia

  • Jadenu (6)TGA ARTG 286751 286761 293497 registered 2018-03-15 · 90 mg, 180 mg, 360 mg · Novartis Pharmaceuticals Australia Pty Ltd
  • Exjade (6)TGA registered 2006-07-06 PBS listed · Novartis Pharmaceuticals Australia Pty Ltd

New Zealand

  • Exjade (7)medsafe data sheet confirmed · 125 mg, 250 mg, 500 mg · Novartis New Zealand Ltd · Jadenu could not be separately confirmed as registered in New Zealand from the sources reviewed; only the Exjade data sheet was located. Deferasirox itself is confirmed authorised via Exjade.
View brands in additional countries.

European Union

Exjade (4), Deferasirox Accord / Deferasirox Mylan (generics) (4)

This page provides general reference information about deferasirox and is not a substitute for advice from the clinician managing your iron-overload treatment. Regular monitoring is required throughout treatment.

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