Asunra - pls guide

My 3 year old daughter is on asunra since one year. Her current ferritin is 2200. Her current dose in 200mg per day once in mrng. Current weight is 12 kg.

pls guide. Is this ok?

Rima,
I guess your dosage is low, ideal dose for Asunra is 32.6 mg / kg and may be increased upto 40 mg / kg for acute cases. Kindly consult with your doctor before changing the dosage.

Also, as you may have read other posts, Asunra usually takes about an year to really show any change on ferritin level but is working internally, so persist with the chelation regimen.

Hi Rima, welcome to Thalpal!

Can you tell us your daughter's weight? You yourself can decide an optimum safe dosage for your daughter. It's generally 30mg/kg under normal iron level overload, which is fine for your daughter as of now, so multiply 30 by your daughter's weight and that dosage should be fine.

-P.

Hi Rima
Your daughters dose is low. Her chelating dose should be 350mg. You could start with 300mg and see how it reflects on her ferritin after a couple of months. Also splitting the dose will give faster results and fewer reactions. Make sure to monitor her liver and kidney functions as well.
take care

Rima,

I agree that your daughter's dose is low, her iron level is high enough that she needs a little more chelation.  She should be on a higher dose and you should split the dose so that she is having it in the morning and in the evening.  Please consult with your physician as well and ensure that she is monitored adequately. 

Best of luck,

Sharmin

D/a  thank u for your reverts.

Will speak to doctor regarding increase of dose.

Pls guide me how to give in 2 splits? As currently we give her 200 mg of asunra first thing in the morning after brush. After 30 mins we give her breakfast. Hope this is correct.

In the evening when to give as it needs to be taken on empty stomach? Before taking asunra - atleast for how many hours she should have not taken any food/drink? pls guide.

D/a  thank u for your reverts.

Will speak to doctor regarding increase of dose.

Pls guide me how to give in 2 splits? As currently we give her 200 mg of asunra first thing in the morning after brush. After 30 mins we give her breakfast. Hope this is correct.

In the evening when to give as it needs to be taken on empty stomach? Before taking asunra - atleast for how many hours she should have not taken any food/drink? pls guide.

Hi dear,

I guess Asunra also supplies the tablets in a 100 mg dosage (I believe so as I did took some of those in past), so next time you run out of stock on Asunra, you can order a 100 mg tablets. So then, you can do like, give 100 mg in the morning and rest of the 100 mg in evening.

Yes, that's correct, one shouldn't eat till 30 minutes have passed after taking Asunra.

And while giving the other half dosage in the evening, you can give her 3 hours after she eat the last thing, so 3-4 hours gap is enough. Like for me, I eat around 1:30 in the noon and take Asunra at around 5:00 PM in the evening, so there's a gap of 4.5 hours, which is sufficient.

Rima,
My daughter is 6 yrs old and when we used to split her exjade dose (now we don't as she is on a very low exjade dose due to lower ferritin level), we used to give her half the dose in the morning, immediately when she woke up. After morning routine and shower, she used to eat breakfast . so the gap betwwen 1st exjade and food used to be around 30 to 45 minutes. In the evening, we used to give her the 2nd dose, right after she came back from her school -even before she changed ...then, she used to change and settle down...then we used to give her some fruit to eat..again, the gap between exjade and eating food used to be between 20 to 30 minutes. we never saw any issue with efficiency of chelation. The key thing was the right dose/kg of her weight....not the gap between exjade and food. If you read any other post by me, we also used chocolate while taking exjade and did not see any issue.....my daughter's ferritin is currently between 300 and 600...so i feel this regimen is perfectly fine and very manageable. Hope this helps...

Hi Rima
If the dose is increased to 300mg, you could split the dose to 200mg and 100mg.There was a time when I used to wait 30min before giving the med and it used to be really difficult. For more than a year now I give him his med at the stipulated time irrespective of the fact if he has eaten something just before or soon after giving him asunra. It does not affect the efficacy of the med as from last year my sons ferritin has come down from 1500ng to 400ng. Also I give him his first dose in the afternoon and the second just before bedtime.

I currently take 1600 mg, so 800 in morning and other 800 in evening as I mentioned earlier. But when I was taking uneven dosage like yours, 1200 mg, I used to take 800 mg as soon as I wake up, my dad gives me the Asunra at 7 and then I again sleep up to 9:30 AM or so. The other 400 mg dose I used to take at 16:30 (4:30 PM) in the evening.

Bostonian and Maha, thanks for the feedback on Exjade and eating. I really think the most important thing is taking the med and if taking it with food makes it easier and still does the job, then we shouldn't be too concerned about waiting to eat after taking the med.

Bostonian and Maha, thanks for the feedback on Exjade and eating. I really think the most important thing is taking the med and if taking it with food makes it easier and still does the job, then we shouldn't be too concerned about waiting to eat after taking the med.

I've tried this few times as well, especially when I had hypoglycemia (low sugar level) immediately after taking Asunra, I eat a lot of food and I still eat immediately sometimes and there were no side effects or lack of effects so I think we can confirm that empty stomach does not play much role here.