L1 does need regular monitoring, as does Exjade. These drugs should only be taken under a doctor's supervision. There have been at least 8 known deaths associated with exjade. This resulted in a change in the recommendations regarding monitoring. Creatinine levels need to be monitored frequently and patients must be taken off exjade if the levels get high as the result can be kidney failure and death. All the patients who died had a prior history of health problems, but proper monitoring may have saved their lives. White cell counts need to be watched with both drugs.
Exjade has been delayed in India and I believe the lawsuits Novartis has filed have been responsible for this. Novartis is concerned that Indian companies will copy Exjade once it is released in India, as Cipla has done with L1. My sympathies to the mighty Novartis, but there are international agreements that DO permit countries to manufacture their own versions of life-saving drugs. So far, Indian courts have sided with the needs of patients and we can hope they continue to take this pro-patient attitude. There are many good people working for Novartis to develop these drugs and get them to patients, but unfortunately, like any multinational corporation, these are not the same people that make the financial decisions.