ferric carboxymaltose

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

GI disorders associated with malabsorption of fat-soluble vitamins or phosphate, concurrent/prior use of medications that affect proximal renal tubular function, hyperparathyroidism, vitamin D deficiency, or malnutrition (↑ risk of hypophosphatemia);
OB: Severe hypersensitivity reactions may occur that can lead to bradycardia in fetus, especially during 2nd and 3rd trimesters;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children <1 yr (safety and effectiveness not established);
Geri: Older adults may be more sensitive to effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypertension, hypotension

Derm: flushing

F and E: hypophosphatemia

GI: constipation, ↑liver enzymes, nausea, vomiting

Local: extravasation with skin discoloration

Neuro: dizziness, dysgeusia, headache

Misc: HYPERSENSITIVITY REACTIONS(INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Solution for injection: 50 mg/mL

Route/Dosage ⬆ ⬇

Iron Deficiency Anemia in Patients Who Cannot Tolerate or Have an Unsatisfactory Response to Oral Iron

IV (Adults and Children ≥1 yr and ≥50 kg): 750 mg initially, followed at least 7 days later by a second dose of 750 mg (total cumulative dose = 1500 mg/course) OR 15 mg/kg (max dose = 1000 mg) as a single dose.
IV (Adults and Children ≥1 yr and <50 kg): 15 mg/kg initially, followed at least 7 days later by a second dose of 15 mg/kg.

Iron Deficiency Anemia in Patients with Non-Dialysis-Dependent Chronic Kidney Disease

IV (Adults ≥50 kg): 750 mg initially, followed at least 7 days later by a second dose of 750 mg (total cumulative dose = 1500 mg/course) OR 15 mg/kg (max dose = 1000 mg) as a single dose.
IV (Adults <50 kg): 15 mg/kg initially, followed at least 7 days later by a second dose of 15 mg/kg.

Iron Deficiency in Heart Failure

IV (Adults ≥70 kg): Hgb >14–<15 g/dL: 500 mg initially, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%. Hgb 10–14 g/dL: 1000 mg initially, then 500 mg at Wk 6, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%. Hgb <10 g/dL: 1000 mg initially, then 1000 mg at Wk 6, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%.
IV (Adults <70 kg): Hgb >14–<15 g/dL: 500 mg initially, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%. Hgb 10–14 g/dL: 1000 mg initially, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%. Hgb <10 g/dL: 1000 mg initially, then 500 mg at Wk 6, then 500 mg at Wk 12, Wk 24, and Wk 36 if serum ferritin <100 ng/mL or if serum ferritin 100–300 ng/mL with transferrin saturation <20%.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

A colloidal iron complex that releases iron into circulation.

Therapeutic effects:

Improvement in indices and symptoms of iron deficiency.
Improvement in exercise capacity in patients with HF.

Classifications ⬆ ⬇

Therapeutic Classification: antianemics

Pharmacologic Classification: iron supplements

Pharmacokinetics ⬆ ⬇

Absorption: Iron released from colloid is rapidly bioavailable.

Distribution: Unknown.

Metabolism/Excretion: Iron is rapidly cleared from plasma and used in hemoglobin formation. Negligible renal elimination.

Half-Life: 7–12 hr.

Time/Action Profile ⬆ ⬇

(improved indices)

ROUTE	ONSET	PEAK	DURATION
IV	1–2 mo	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose of ferric carboxymaltose to patient. Ask patient if they have a history of reactions to parenteral iron products. Advise patient to read Patient Information before starting and periodically during therapy in case of changes.
Advise patient to notify health care professional if signs and symptoms of hypersensitivity reaction occurs.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications. Instruct patient to avoid taking iron supplements during therapy.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Severe maternal reactions (circulatory failure, severe hypotension, shock, anaphylaxis) may occur, increasing risk for preterm delivery and low birth weight. May cause fetal bradycardia, especially in 2nd and 3rd trimester. Monitor breastfed infants for GI toxicity (constipation, diarrhea).

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Indications ⬇

Contraind./Precautions ⬆ ⬇