ferumoxytol

REMS

Treatment of iron deficiency anemia in patients with chronic kidney disease (CKD).
Treatment of iron deficiency anemia in patients who do not tolerate or have experienced inadequate response with oral iron.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to ferumoxytol or any other IV iron product;
Evidence of iron overload;
Anemia not due to iron deficiency;
Lactation: Lactation.

Use Cautiously in:

MRI;
Multiple drug allergies (↑ risk for anaphylaxis);
OB: Severe hypersensitivity reactions may occur which can lead to bradycardia in fetus, especially during second and third trimesters;
Pedi: Safety and effectiveness not established in children;
Geri: Consider age-related ↓ in hepatic, renal, or cardiac function, and concurrent diseases or other drug therapy; older adults with multiple comorbidities may experience worse outcomes if develop hypersensitivity reactions.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypertension, HYPOTENSION, peripheral edema

GI: constipation, diarrhea, nausea

Hemat: iron overload

Neuro: dizziness

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

May ↓ absorption of concurrently administered oral iron preparations.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 30 mg elemental iron/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 510 mg initially, followed by 510 mg 3 to 8 days later. Course may be repeated after 1 mo.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Consists of a superparamagnetic iron oxide coated with a carbohydrate shell; when the iron-carbohydrate complex enters the reticuloendothelial system (RES), iron is released from the iron-carbohydrate complex within macrophages. This iron can either enter the intracellular storage iron pool or be transferred to erythroid precursor cells for incorporation into hemoglobin.

Therapeutic effects:

Improvement in anemia.

Classifications ⬆ ⬇

Therapeutic Classification: antianemics

Pharmacologic Classification: iron supplements

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability of iron-carbohydrate complex, however iron is not liberated until incorporation into RES.

Distribution: Taken up by RES.

Metabolism/Excretion: Iron can either become part of intracellular ferritin or be transferred to erythroid precursor cells.

Half-Life: 15 hr.

Time/Action Profile ⬆ ⬇

(effect on anemia)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	unknown	up to 1 mo

Patient/Family Teaching ⬆ ⬇

Explain purpose of iron therapy to patient.
Advise patients to avoid MRI studies during and for 3 mo following ferumoxytol therapy.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to report signs and symptoms of hypersensitivity reactions (rash, itching, wheezing, dizziness, swelling, and breathing problems) to health care professional immediately.
Rep: Advise female patient 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.

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Indications ⬇