What is the optimum deferasirox dose for patients with high iron intake?
Some patients with high transfusion burdens will probably have rising ferritin levels and HICs if treated with the approved doses of 20 to 30 mg/kg/d. If so, alternative strategies will be obligatory. These might include higher daily doses (which may cause more diarrhea12), twice-daily dosing, or possible combination regimens with DFO. The latter option would offer lower average price than deferasirox alone (and ideally better net iron chelation) but would lose the advantages of an oral drug. A combination of the 2 oral drugs, deferasirox and deferiprone, requires detailed study before it can be safely recommended. What is the proper role for deferiprone? Based on side-effect profile alone, in my opinion, deferiprone is likely to remain a “second-line” drug to deferasirox and DFO. This is not to say that deferiprone will not have a crucial role. In particular, deferiprone plus DFO in some combination appears to be the emerging “treatment of choice” for significant cardiac dysfunction f
