Exjade dosage Vs. Desferal dosage

I was wondering if the dose of Exjade and Desferal are as effective as each other in terms of mg/kg.

For example I take about 54mg/kg Desferal for 5 days a week (yep shortage issues) and I want to either switch completely to Exjade or Combine it like 5 days Desferal and 2 days exjade. Then would I need to take the same dose? I'm asking this because JSF starts Exjade/Asunra @ 20mg/kg, so would I be slacking during my Exjade days @ 20mg/kg or is it as good as Desferal in high dose like mine?

Sajid,

First of all, I am not aware of any combination therapy trials with regards to Desferal and Exjade. Are you sure its a good idea to start the combination therapy.

20mg/kg of exjade seems a little low for your age, my daughter who is only five takes 20mg/kg. It is best to start with a lower dose but eventually you might require upto 50mg/kg for seven days. However, I suggest talk to your doctor about the combination therapy.

Hi C.F ,
i want to ask wat dosage will be for me  .. as i m 21 years old and my weight is 45 kg ...
i have not started exjade yet but my doc want to start soon .... thats why i m asking about the dosage details for me .....

Take Care
Umair

Umair,

I will see if I can get an answer for you. 

sharmin

Umair,

The eventual dosage for your body weight would be 1350 mg per day. The formula is 30 mg per kg body weight. However, when first starting, it is easier to avoid side effects if you start with a lower dose for 1-2 weeks. Perhaps 1000 mg daily. If you do switch to exjad soon, you might want to go as high as 1500 mg per day until your ferritin gets below 1000.

Hi Andy ,
Thanx for the sparing time to reply from the busy life in conference and for the informative reply .... its helped me alot to understand about my dose of Exjade ....

If you do switch to exjad soon, you might want to go as high as 1500 mg per day until your ferritin gets below 1000

i think that's why my doctor want my ferritin below 1000 to start and maintain low dose of Exjade ....

1) could anybuddy gues that how much Iron we get with one unit of blood ??
2) could you tell how much iron exjade removes with one proper dose  ??...
on my last transfusion ( date 27-09-08 ) my pre trasfusion Hg was 7.7 ( 77 ) ,  after the stomach pain  and course of anti-biotics , i think my pre-Tx Hg will b very low this time again , i want few Txs in a short time thats why i m asking about , how much iron would i get with three transfusions in a week ?? .. ( if i can manage to get blood ,, hopefully, i will )....
and it will b safe to take Hg to that much low to take 11 Hg ?? ...

Best Regards
Take care
umair

Umair

I am not sure about chelation but I have seen in the conference myself that the combination therapy is really working. So please do use Desferal and L1. Andy correct me if i am wrong, Desferal takes out iron from the liver and other organs and L1 is good on heart.

Shilpa is on combination and there is another person Lilianof Malaysia and they are keeping the iron well under control.

So Umair buck up and please donot take this lightly. I am going to be asking you again and again wether you are complying or not.

Umair

I wil chk tomm with some doctors as to how much iron we can get with one pkt of blood. Lets see what they say.

Hi Puja ,
Thanx for the info you posted .. its realy usefull ...
i m on combination therapy and you can see the results in my post
http://www.thalassemiapatientsandfriends.com/index.php?topic=1689.0;highlight=especialy+to+andy

i m still on combination therapy .. and complying on plan that my doctor gave me ..
i will reply you in details very soon this time i got a go ...

Take Care
Umair

Hi Umair,

A doctor from Novartis,while giving us an introduction to Asunra,told us that a unit of blood (approx 300 ml) contains 250 mg of iron.

Zaini.

Hi Umair,

I apologize for the late reply. With the economy turmoil in North America and the worry in financial markets, the real heat is on federal regulators, we have been working round the clock and busy in real time. Anyhow, Zaini is rigth, one unit of blood contains approx 250mg of iron. The average dose of desferal infusion for 6-8 hours removes approx 6-10mg of iron. The iron accumulation ofcourse depends on the frequency of blood transfusion and number of days of desferal infusions.

Exjade on a head to head trail with desferal shows as effective as desferal (if given in high doses of 40mg/kg) so an anology can be made that daily exjade dose will remove about the same iron as desferal.

Andy is right, start with a lower dose of 1350mg and climb to 1800mg with time.

Regards.

Thank you Zain & C.F ,
do you have any idea about the efficiancy of Combination therapy and alone  Ferriprox , how effecient these are .. are these more efficiant than the Exjade ... can you tell me about theese ??..
i want to know that after having a Tx how much Desferals , Exjade or Ferriprox i need ...
Thank you again for the replies ...

Best Regards
Take Care
Umair

I apologize for the late reply. With the economy turmoil in North America and the worry in financial markets, the real heat is on federal regulators, we have been working round the clock and busy in real time. Anyhow, Zaini is rigth, one unit of blood contains approx 250mg of iron. The average dose of desferal infusion for 6-8 hours removes approx 6-10mg of iron.

Only 6-10 mg of iron

Umair,

I think ferriprox alone won't be enough unless your ferritin is really really low,Once when we were moving and i was in a bit hectic situation ,i was unable to do desferal and in my mind i was a bit satisfied that she is taking ferriprox,so it's not like she is not chelating at all,but in those days when her ferritin was tested it came back 2300 something,which definitely was a hit in my face and i immediately started desferal,that was the highest level she ever reached.One of our members Smurfette was on ferriprox alone but her ferritin was like 300 or something,so i guess combination therapy is best for you,at least for right now.

Zaini.

Yeah Zaini ,
thinking the same .. 250 mg per Tx and then minus only 6-  10 mg per desferal therapy .. its mean i have to be on desferal on daily basis after a Tx , no rest between to Tx , if i use Desferal alone 25 times then it will remove the iiron equel to one Tx  .. and i m unable to have 25 desferal therrapies in 15 day ( between two transfussions ) ... combination therapy is the only choice ...

Once when we were moving and i was in a bit hectic situation ,i was unable to do desferal and in my mind i was a bit satisfied that she is taking ferriprox,so it's not like she is not chelating at all,but in those days when her ferritin was tested it came back 2300 something

for this i want mention here my exp ...
i m using ferriprox  from Jan-2007 , when  was a little above 13000 ... To jan-2007 to March-208 i used ferriprox alone ( a few desferal therpies in home  ) my SF came to 9500.. then i added  pump and desferal to my chelation process . and now my SF is below 3000 .. you can see the difference .. its mean desferal makes big difference ......
in Smurfette's case , i think she need's less Tx's or Iron is stored in somewhere else in er body ... as i heard that one of the forum member's SF were normal but when she had an SQUID test iron found in her heart, in a high Levels ...

Take Care
umair

Smurfette reached her low ferritin level through hard work. Now that it is low, it is much easier to maintain. Her levels are for real and she keeps them low. I've been very proud of her effort.