Q: My sister, aged 9 years, has Thalassaemia major. She is taking Desferal infusion. I heard a new drug called Exjade has been approved which is much more effective than Desferal and can be taken orally. Is this drug available in India? What is the approximate cost? Are there any issues moving from Desferal to Exjade?

A:Desferal (deferoxamine) is the usual therapy for iron overload. It has been in use for decades and nearly all its properties (efficacy, side effects) are very well known. Exjade is the brand name of a medicine called deferasirox. It has just been approved in USA only. Its advantage is that it is taken by mouth. However being a new medicine it has undergone limited controlled clinical trials before being launched. Unless the medicine is consumed by a very large number of patients, the information on its properties cannot be fully understood and documented. It is quite common for new long term side effects to appear on new drugs years after it is marketed. The product is not cleared for use in India as of date.