Dose adjustment

Deferoxamine (DFO)

• Reduce dose of DFO when SF <2000 ng/mL (evidence level III, recommendation grade B)
• Discontinue DFO when SF >1000 ng/mL (evidence level III, recommendation grade B), resume when SF >1000 ng/mL

Deferasirox (DFX)

• Discontinue DFX when SF <500 ng/mL. However, for DFX, lower SF levels may be safer, though this has not yet been demonstrated in sizable studies and is an area for future investigation (evidence level III, recommendation grade B)

For DFX, follow the product monograph if the creatinine is elevated (evidence level III, recommendation grade B) http://www.ask.novartispharma.ca/download.htm?res=exjade_scrip_e.pdf&resTitleId=689 http://www.ask.novartispharma.ca/download.htm?res=jadenu_scrip_e.pdf&resTitleId=1183