Exjade and Jadenu (deferasirox) are Novartis iron chelators for chronic iron overload, sold as tablets for oral suspension, film-coated tablets and granules that are dosed differently, and none of them needs a cold chain.

The US Exjade label (Novartis Pharmaceuticals Corporation, DailyMed) lists tablets for oral suspension of 125 mg, 250 mg and 500 mg, supplied in bottles of 30. Exjade 500 mg is therefore a US tablet for oral suspension, not a film-coated tablet. The UK emc lists Exjade only as film-coated tablets of 90 mg, 180 mg and 360 mg, so a UK buyer will not find a 500 mg Exjade there. Tell us the formulation and strength your destination registers, and M Care Exports confirms what we can supply against it.

We compare only on label facts and do not recommend either. Exjade in the US is a tablet for oral suspension of 125, 250 or 500 mg, stirred in water, orange juice or apple juice and taken on an empty stomach at least 30 minutes before food. Jadenu in the US is a film-coated tablet or Sprinkle granules of 90, 180 or 360 mg. The tablets are taken with water or other liquids, on an empty stomach or with a light meal, and may be crushed and mixed with soft food for patients who have difficulty swallowing; the granules are sprinkled on soft food. The Jadenu label states that the dose should be about 30% lower when converting from Exjade: the transfusional starting dose of 20 mg/kg/day for Exjade compares with 14 mg/kg/day for Jadenu. Both carry the same boxed warning.

Drugs@FDA lists AB-rated entries for the Exjade tablets for suspension from eight firms. The EMA lists Deferasirox Accord as a generic of Exjade, authorised on 9 January 2020, as film-coated tablets of 90, 180 and 360 mg. The UK emc SmPC for Exjade states that deferasirox is also available as film-coated and dispersible tablets under other tradenames as generic alternatives to Exjade. Which version a destination accepts depends on its regulator, and M Care Exports confirms this per enquiry.

We do not publish prices. The landed cost depends on whether you want the originator Exjade or Jadenu, a regulator-registered generic or an Indian-made line, the formulation and strength, the pack size, the quantity, the registration route in your destination and Incoterms. The labels we read give room-temperature storage or no special storage conditions, so no cold chain is needed. M Care Exports quotes per destination once we have the formulation, strength and quantity.

The dose depends on the formulation, so read the label for the product you hold. The US Exjade label gives a starting dose of 20 mg/kg once daily for transfusional iron overload and 10 mg/kg once daily for non-transfusion-dependent thalassaemia. The US Jadenu label gives 14 mg/kg and 7 mg/kg respectively. The UK Exjade film-coated SmPC gives a starting dose of 14 mg/kg/day for transfusional iron overload, with alternative starting doses by transfusion burden, and 7 mg/kg/day for non-transfusion-dependent thalassaemia. Doses are rounded to the nearest whole tablet. Prescribing decisions rest with the treating clinician.

Both US labels carry a boxed warning for renal failure, hepatic failure and gastrointestinal haemorrhage. The US Exjade label requires renal function weekly in the first month after starting or changing the dose, then at least monthly, liver tests every 2 weeks in the first month, then at least monthly, and monthly serum ferritin and blood counts. It also requires auditory and ophthalmic testing before the start and at regular intervals. The UK SmPC adds warnings on skin reactions, hypersensitivity, metabolic acidosis and hyperammonaemic encephalopathy. Adverse reaction frequencies are in the full label for the product you supply.