Overview
Ferric carboxymaltose is an intravenous iron preparation used to treat iron deficiency anemia when oral iron is ineffective or cannot be used. It consists of a polynuclear iron(III)-hydroxide core stabilized by carboxymaltose, allowing controlled iron release with lower risk of free iron toxicity compared to older IV iron formulations.
Mechanism of Action
Ferric carboxymaltose releases iron into the bloodstream, where it binds to transferrin for transport to bone marrow and incorporation into hemoglobin. The carboxymaltose shell stabilizes the iron core, minimizing release of free iron that can cause oxidative stress.
Indications
- Iron deficiency anemia in adults with intolerance or unsatisfactory response to oral iron
- Iron deficiency anemia in adults with chronic kidney disease
- Iron deficiency anemia in adults with inflammatory bowel disease when oral iron is ineffective
Dosage
Dose is based on body weight and hemoglobin level. Typically: 15 mg/kg up to 1000 mg per infusion, may be repeated after at least 7 days if needed. Maximum single dose: 1000 mg. Maximum cumulative dose: 2000 mg per course. Administered as slow IV injection or infusion.
Contraindications
- Known hypersensitivity to ferric carboxymaltose or any component
- Evidence of iron overload
- Anemia not caused by iron deficiency
Side Effects
- Nausea
- Headache
- Dizziness
- Hypotension
- Injection site reactions
- Flushing
- Elevated liver enzymes
- Hypophosphatemia (usually transient)
Interactions
- May reduce absorption of oral iron supplements
- Concurrent use with angiotensin-converting enzyme inhibitors may increase risk of hypotension