CatchR,
My daughter also experiences acid reflux with Exjade (and now on Jadenu). She takes Zantac in the morning and evening, 150mg each time to keep the acid reflux under control and we make sure she takes the medicine with food. Also, when the ferritin reaches 300 we lower the exjade/jadenu dose (take every day but lower amount) and then again bump it up a bit when it passes 500...since her ferritin is now low for many years, she is on a very low dose...infact, her dose did not change from last 3 to 4 years even though she grew.
In my opnion, 40mg/kg is very high dose when ferritin level is low. It should be close to 15 or 20mg/kg of exjade to maintain ferritin between 300 to 500. what I have seen is there is no absolute dose value for exjade/jadenu, it should be reduced or increased based on ferritin levels over a period of time.