Packed red cells (transfusion-dependent), Deferasirox (ferritin > 1000 µg/L or after 10–20 transfusions), Deferiprone (alternative, or with deferasirox for heart iron), Folic acid (not transfused or poorly transfused)
Advice and when to refer
Thalassaemia trait (minor): No treatment; no iron unless ferritin is low; test the partner (HbA2) before pregnancy (NHM 2016, latest; TIF 2025)
Investigations
First visit
CBC with indices and peripheral smear — Microcytosis out of proportion to anaemia.
Haemoglobin electrophoresis (HPLC) — Confirms trait or major; HbA2 over 3.5% in beta-thalassaemia trait.
Serum ferritin — Exclude iron deficiency before HPLC interpretation.
Only if indicated
HPLC of the partner — Before or early in pregnancy — prenatal diagnosis if both carriers.
HBsAg, anti-HCV, HIV — Transfused patients.
Follow-up and monitoring
Pre-transfusion haemoglobin — Keep 9.5–10.5 g/dL in thalassaemia major.
Ferritin every 3 months; cardiac/liver T2* MRI yearly — Iron overload on chelation.
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.