Table 5.

Comparison of intravenous iron preparations available in the United States7,38–42

	LMWD	HMWD	Iron sucrose	Ferric gluconate	Ferumoxytol
Brand name	INFed®	DexFerrum®	Venofer®	Ferrlecit®	Feraheme®
Molecular weight (kD)	73	165	43.3	37.5	731
Labeled indication	Iron deficiency anemiaa	Iron deficiency anemiaa	Iron deficiency anemia in patients with CKD	Iron deficiency anemia in adults and children aged ≥6 years with CKD and receiving dialysis and supplemental epoetin	Iron deficiency anemia in adults with CKD
Dosing and administration
Test dose required	Yes Initial test dose of 0.5 mL required	Yes Initial test dose of 0.5 mL required	No	No	No
Adult recommended dose	According to LBW and observed Hb concentration: dose (mL) = 0.0442 (desired Hb − observed Hb) × LBW + (0.26 × LBW) eg, 70 kg adult with Hb range of 3–10 g/dL will require 55–33 mLb	According to LBW and observed Hb concentration: dose (mL) = 0.0442 (desired Hb − observed Hb) × LBW + (0.26 × LBW) eg, 70 kg adult with Hb range of 3–10 g/dL will require 55–33 mL	HDD-CKD: 100 mg slow IV injection (2–5 min) or infusion of 100 mg in max 100 mL normal saline over 15 min at each dialysis session for a total cumulative dose of 1000 mg NDD-CKD: 200 mg slow IV injection (2–5 min) on five separate occasions over 14 days for a total cumulative dose of 1000 mg PDD-CKD: total cumulative dose of 1000 mg by slow infusion in three divided doses over 28 days	125 mg in 10 mL diluted in 100 mL normal saline for IV infusion over 1 hour. Most pts will require a cumulative dose of 1000 mg delivered over eight sessions at sequential dialysis treatments	510 mg followed by a second 510 mg dose 3–8 days later administered undiluted as IV injection up to 1 mL/sec
Dosage adjustments	None	None	None	Lower doses may be required in elderly patients	None

Note:

^aOnly LMWD and HMWD have a broad indication for the treatment of iron deficiency anemia;

^banecdotally, total doses of 1 to 1.5 g LMWD are commonly used in clinical practice.

Abbreviations: LMWD, low molecular weight dextran; HMWD, high molecular weight dextran; CKD, chronic kidney disease; LBW, lean body weight; Hb, hemoglobin; HDD-CKD, hemodialysis dependent-chronic kidney disease; IV, intravenous; NDD-CKD, nondialysis dependent-chronic kidney disease; PDD-CKD, peritoneal dialysis-chronic kidney disease.