As with desferal, Exjade can cause hearing loss. It is not a common side effect, but it can occur. I don't think that the effects of years of desferal use an be discounted, ether, so it could be either drug or a combination that has led to this. The three chelators currently available can all be used in combination of two of the three, so Ferriprox and Exjade can be used together. This is being done at some of the US centers and has also been trialed in Greece. Results are good and somewhat comparable to the Ferriprox/desferal combo. With liver iron rising, a combination is in order. The one precaution with Exjade/Ferriprox used together is that white cell tests are advised on a weekly basis. One other thing that can be tried is splitting the Exjade into two doses, taking half in the morning and half later in the day. This will give a true 24 hour chelation period, which cannot be accomplished by once daily dosing. We have seen this method used by patients for over 4 years now and it definitely works. Iron stores drop, and side effects are lessened, as only half a dose is taken at once.