Deferasirox (JADENU / JADENU SPRINKLE)

Contraindicated when eGFR is below 40 mL/min/1.73 m2. With baseline eGFR 40 to 60, reduce the starting dose by 50%. Obtain duplicate baseline serum creatinine measurements and evaluate renal glomerular and tubular function. Patients with baseline impairment or increased acute-kidney-injury risk need at least weekly renal monitoring during the first month, then at least monthly. Subsequent renal deterioration has age- and indication-specific interruption or reduction rules that must be checked in the complete label; this is not that complete algorithm.

At baseline eGFR 40-60 mL/min/1.73 m2, reduce the indication-specific starting dose by 50%. Do not start, and discontinue treatment, below 40. Use an age-appropriate eGFR equation and assess both glomerular and tubular function. In adults treated for transfusional overload, a creatinine increase of at least 33% requires repeat testing within one week; if persistent, reduce the daily dose by 7 mg/kg. The pediatric and non-transfusion-dependent thalassemia algorithms differ and must be read separately. Pediatric volume-depleting illness warrants interruption or consideration of interruption according to the indication. Exjade-to-Jadenu conversion uses a dose about 30% lower; this formulation conversion is not the same as a renal reduction. This summary does not reproduce every on-treatment adjustment.