Table I.
Some characteristics of the different intravenous iron formulations.
| Iron gluconate | Iron sucrose | Low molecular weight iron dextran | Ferric carboxymaltose | Iron isomaltoside 1000 | High molecular weight iron dextran | Ferumoxytol | |
|---|---|---|---|---|---|---|---|
| Carbohydrate shell | Gluconate (monosaccharide) | Sucrose (disaccharide) | Dextran (branched polysaccharide) | Carboxymaltose (branched polysaccharide | Isomaltoside (linear oligosaccharide) | Dextran (branched polysaccharide) | Polyglucose sorbitol carboxymethylether |
| Complex type | Type III Labile and weak | Type II Semi-robust and moderately strong | Type I Robust and strong | Type I Robust and strong | Type I Robust and strong | Type I Robust and strong | Type I Robust and strong |
| Molecular weight (kD) | 289–440 | 30–60 | 165 | 150 | 150 | 265 | 750 |
| Initial distribution volume (L) | 6 | 3.4 | 3.5 | 3.5 | 3.4 | 3.5 | 3.16 |
| Plasma half-life (h) | 1 | 6 | 20 | 16 | 20 | 60 | 15 |
| Labile iron release | +++ | ± | - | - | - | - | - |
| Direct iron donation to transferrin (% injected dose) | 5–6 | 4–5 | 1–2 | 1–2 | <1 | 1–2 | <1 |
| Test dose required | No | Yes/No (*) | Yes | No | No | Yes | No |
| Iron content (mg/mL) | 12.5 | 20 | 50 | 50 | 100 | 50 | 30 |
| Maximal single dose (mg) | 125 | 200 | 20 mg/kg | 15 mg/kg (max 1,000 mg in one infusion) | 20 mg/kg | 20 mg/kg | 510 |
| Premedication | No | No | TDI only | No | No | TDI only | No |
| Life-threatening ADE (×106 doses) | 0.9 | 0.6 | 3.3 | ?? | ?? | 11.3 | ?? |
Legend: ADE: adverse drug effect; TDI: total dose infusion;
(*)
Only in some countries in the European Union.