Appropriate Dosage of Exjade ?

[Margie]

My hematologist is talking about starting Exjade as my ferritin count is over 1400. He said he would start on a low dosage and moniter it closely. When I asked what dosage he would start with, he said 1000 milligrams in the morning and another 1000 at night. Does this sound like a "small dose"? Maybe someone who is on Exjade will know. My insurance does cover the drug, but at this level, I can not afford the copay.

age-69 Transfusion dependent. Absolute Neutrophip count .3 to .6
Platelets - 25

[Marlene]

That does not seem like a low dose to me....Here's the dosing information so you can see that 2000 mg/day seems high. Also, Exjade is usually taken only 1x/day. I would ask him why he's not following the recommended dosing/admin schedule. Many side effects are dose related. He should monitor your liver and kidney function weekly for the first month, especially at that dose.

Also, much depends on how frequent your transfusions are. You may not need a maximum dose if you're getter red cells once a month versus weekly.

http://www.rxlist.com/cgi/generic/exjade_ids.htm

[Birgitta-A]

Hi Margie,
The recommended initial daily dose of Exjade is 20 mg/kg body weight. You will get info from this link:

http://www.rxlist.com/cgi/generic/exjade_ids.htm

I think 1000 mg twice a day is a high initial dose .
Kind regards
Birgitta-A

[Marlene]

http://www.us.exjade.com/hcp/about/a.../calculator.do

[Margie]

Many thanks to both of you for your help. It gives me some confidence to ask the doctor about this again. Also the calculator was great. We were right, the dosage that the doctor prescribed is double what it should be according to the manufacturer's website.

[MaryAlisha]

My sister takes 3 500mg tablets 1x a day. That was the initial dose and we are going on month 3 with no change in dosage. I hope this helps some. So I guess that would be 1500mg a day.

[MaryAlisha]

She also hasn't had any side effects yet. Thank God..

[Marlene]

Hi Margie,

I'm glad you'll be able to use this information with doc to ensure proper dosage and admin of Exjade. Also, you should have a basline hearing and vision test done prior to starting your Exjade. When John started his Exjade, he started at 500mg/day.

I recently saw one of those University medical programs where they were assessing failures in medical processes. They talked about the various checks in place to ensure that patients get the right dose and right drug. The most interesting point they made was that the patient is the last check in this system and they should feel empowered to question their healthcare provider if things don't seem right. The biggest hurdle to empowering patients however is the doctor. They don't create an evironment where patient feel secure enought to question the doc. BTW...this was presented by a doctor. So I am glad that you are taking the time to understand your meds so you can avoid a costly mistake. It's not that anyone is intentionally trying make a mistake, it's just that we are all human and things get overlooked.


Marlene