Drug Guide
Ferric Carboxymaltose
Classification
Therapeutic: Iron deficiency anemia treatment
Pharmacological: Parenteral iron preparation
FDA Approved Indications
- Treatment of iron deficiency anemia in adults when oral iron is ineffective or cannot be used
Mechanism of Action
Ferric carboxymaltose delivers bioavailable iron that integrates into hemoglobin and iron stores, effectively replenishing iron levels in the body.
Dosage and Administration
Adult: Typically 750 mg IV infusion over 15 minutes, repeated as needed based on iron levels and body weight.
Pediatric: Approval varies; consult specific guidelines for pediatric dosing.
Geriatric: Adjusted based on renal function and iron deficiency severity.
Renal Impairment: Dose adjustments may be necessary; monitor iron status.
Hepatic Impairment: Use with caution; no specific adjustments established.
Pharmacokinetics
Absorption: Administered IV, bypassing gastrointestinal absorption.
Distribution: Iron binds to transferrin in plasma.
Metabolism: Utilized in erythropoiesis or stored as ferryzin in tissues.
Excretion: Excreted primarily in urine after utilization or recycling.
Half Life: Approximately 8-14 hours.
Contraindications
- Allergy to ferric carboxymaltose or any component of the formulation.
- Anemia not caused by iron deficiency.
Precautions
- Patients with predisposition to iron overload, hemochromatosis, or existing iron overload states.
Adverse Reactions - Common
- Hypersensitivity reactions including anaphylaxis (Uncommon)
- Headache, nausea, flushing (Common)
Adverse Reactions - Serious
- Anaphylaxis, hypotension (Rare)
- Iron overload leading to organ damage (Very rare)
Drug-Drug Interactions
- Potential interference with diagnostic tests for TIBC and serum iron levels shortly after administration.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor hemoglobin, hematocrit, iron levels, and for any allergic reactions during and after infusion.
Diagnoses:
- Impaired tissue perfusion related to anemia
Implementation: Administer IV infusion slowly, monitor vitals and for adverse reactions during and for at least 30 minutes post-infusion.
Evaluation: Assess improvement in hemoglobin and iron stores; monitor for adverse reactions.
Patient/Family Teaching
- Report any symptoms of allergic reactions such as rash, itching, swelling, dizziness, or difficulty breathing.
- Inform about the importance of follow-up blood tests to monitor iron levels.
- Explain the purpose of the infusion and possible side effects.
Special Considerations
Black Box Warnings:
- Anaphylactic reactions can occur; emergency resuscitation equipment should be available during administration.
Genetic Factors: None established.
Lab Test Interference: Can temporarily alter serum iron, TIBC, and iron binding capacity tests.
Overdose Management
Signs/Symptoms: Signs of iron overload including weakness, fatigue, abdominal pain, hemorrhage, hypotension.
Treatment: Discontinue infusion immediately; provide supportive care, chelation therapy with deferoxamine if indicated.
Storage and Handling
Storage: Store at room temperature, protected from light.
Stability: Stable for the duration of the expiration date under specified storage conditions.