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(de fer' a sir ox)Deferasirox may cause serious or life-threatening damage to the kidneys. The risk that you will develop kidney damage is greater if you have many medical conditions, or are very sick because of a blood disease. Tell your doctor if you have or have ever had kidney disease. Your doctor may tell you not to take deferasirox. If you experience any of the following symptoms, call your doctor immediately: decreased urination, swelling in the ankles, legs, or feet, excessive tiredness, shortness of breath, and confusion. For children taking this medication, there is an increased risk that you will develop kidney problems if you get sick while taking deferasirox and develop diarrhea, vomiting, fever, or stop drinking fluids normally. Call your doctor immediately if you experience any of these symptoms. Deferasirox may also cause serious or life-threatening damage to the liver. The risk that you will develop liver damage is greater if you are older than 55 years of age, or if you have other serious medical conditions. Tell your doctor if you have or have ever had liver disease. If you develop any of the following symptoms, call your doctor immediately: yellowing of the skin or eyes, flu-like symptoms, lack of energy, loss of appetite, pain in the upper right part of the stomach, or unusual bruising or bleeding. Deferasirox may also cause serious or life threatening bleeding in the stomach or intestines. The risk that you will develop severe bleeding in the stomach or intestines may be greater if you are elderly, or are very sick from a blood condition. Tell your doctor if you have or have ever had a low level of platelets (a type of blood cell that is needed to control bleeding), or if you are taking any of the following medications: anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven); aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); certain medications to strengthen the bones including alendronate (Binosto, Fosamax), etidronate, ibandronate (Boniva), pamidronate, risedronate (Actonel, Atelvia), and zoledronic acid (Reclast, Zometa); or steroids such as dexamethasone, methylprednisolone (A-methapred, Depo-medrol, Medrol, Solu-medrol), or prednisone (Rayos). If you experience any of the following symptoms, call your doctor immediately: burning stomach pain, vomit that is bright red or looks like coffee grounds, bright red blood in stools, or black or tarry stools. Keep all appointments with your doctor and the laboratory. Your doctor will order laboratory tests before and during your treatment to be sure it is safe for you to take deferasirox and to see if you are developing these serious side effects.
- Always dissolve the tablets for suspension in liquid before you take them. Do not chew or swallow the tablets for suspension whole.
- If you are taking less than 1000 mg of deferasirox, fill a cup halfway (about 3.5 oz/100 mL) with water, apple juice, or orange juice. If you are taking more than 1000 mg of deferasirox, fill a cup (about 7 oz/200 mL) with water, apple juice, or orange juice. If you are not sure how much deferasirox you are to take, ask your doctor or pharmacist.
- Place the number of tablets your doctor has told you to take in the cup.
- Stir the liquid for 3 minutes to completely dissolve the tablets.The mixture may become thick as you stir it.
- Drink the liquid immediately.
- Add a small amount of liquid to the empty cup and stir. Swish the cup to dissolve any medication that is still in the glass or on the stirrer.
- Drink the rest of the liquid.
Before taking deferasirox,
- tell your doctor and pharmacist if you are allergic to deferasirox, any other medications, or any of the ingredients in deferasirox tablets, granules, or tablets for suspension. Ask your doctor or pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: alosetron (Lotronex), aprepitant (Cinvanti, Emend), budesonide (Entocort, Pulmicort, Uceris, in Symbicort), buspirone, cholestyramine (Prevalite), colesevelam (Welchol), colestipol (Colestid), conivaptan (Vaprisol), cyclosporine (Gengraf, Neoral, Sandimmune), darifenacin (Enablex), darunavir (Prezista, in Prezcobix), dasatinib (Sprycel), dihydroergotamine (D.H.E. 45, Migranal), dronedarone (Multaq), duloxetine (Cymbalta), eletriptan (Relpax), eplerenone (Inspra), ergotamine (Ergomar, in Cafergot, Migergot), everolimus (Afinitor, Zortress), felodipine, fentanyl (Actiq, Duragesic, Subsys, others), fluticasone (Arnuity Ellipta, Flovent, in Breo Ellipta, Advair), hormonal contraceptives (birth control pills, patches, rings, or injections), indinavir (Crixivan), lopinavir (in Kaletra), lovastatin (Altoprev), lurasidone (Latuda), maraviroc (Selzentry), midazolam, nisoldipine (Sular), paclitaxel (Abraxane, Taxol), phenytoin (Dilantin, Phenytek), phenobarbital, pimozide (Orap), quetiapine (Seroquel), quinidine (in Nuedexta). ramelteon (Rozerem), repaglinide (Prandin, in Prandimet), rifampin (Rimactane, Rifadin, in Rifamate, in Rifater), ritonavir (Norvir, in Kaletra, Technivie, Viekira Pak), saquinavir (Invirase), sildenafil (Revatio, Viagra), simvastatin (Flolopid, Zocor, in Vytorin), siroliumus (Rapamune), tacrolimus (Astagraf, Envarsus, Prograf), theophylline (Theo-24), ticagrelor (Brilinta), tipranavir (Aptivus), tizanidine (Zanaflex), triazolam (Halcion), tolvaptan (Samsca), and vardenafil (Levitra, Staxyn). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are taking aluminum-containing antacids such as Amphojel, Alternagel, Gaviscon, Maalox, or Mylanta, take them 2 hours before or after deferasirox.
- tell your doctor what over the counter products you are taking, especially melatonin, or caffeine supplements.
- tell your doctor if you have myelodysplastic syndrome (a severe problem with the bone marrow that has a high risk of developing into cancer), or cancer. Your doctor may tell you not to take deferasirox.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking deferasirox, call your doctor.
- stomach pain
- hearing loss
- vision problems
- rash, hives, peeling or blistering skin, fever, swollen lymph nodes
- difficulty breathing or swallowing; swelling of the face, throat, tongue, lips, or eyes; hoarseness
- unusual bruising or bleeding