Table 1.
IV iron formulations available in the United States
| Generic Name | Brand Name (Manufacturer) | Approval Year | Test Dose Needed | Labeled Dosage for Iron Deficiency | IV administration time | Notes |
|---|---|---|---|---|---|---|
| High-molecule-weight iron dextran | DexFerrum (American Regent) | 1954 | Yes | 1000 mg in 10 divided doses or total dose as a single IV infusion | Undiluted at an infusion rate not to exceed 50 mg (1mL)/min | Anaphylactic-type reactions and fatalities reported; resuscitation equipment and trained personnel necessary |
| Low-molecule-weight iron dextran | InFed (Watson) | 1992 | Yes | 1000 mg in 10 divided doses or total dose as a single IV infusion | Undiluted at an infusion rate not to exceed 50 mg (1mL)/min | Anaphylactic-type reactions and fatalities reported; resuscitation equipment and trained personnel necessary |
| Ferric gluconate | Ferrlecit (Sanofi-Aventis); Nulecit (Watson) | 1999 | No | 1000 mg in 8 divided doses (HD only) | 60 minutes diluted in saline; undiluted IV push at 12.5 mg/min | Reactions to benzyl alcohol ingredient |
| Iron sucrose | Venofer (American Regent) | 2000 | No | 1000 mg in 10 divided doses (HD); 1000 mg in 5 divided doses (NDD); 1000 mg in 2 doses of 300 mg and 1 dose of 400 mg (PD) | 2–5 minutes undiluted or 15 minutes if diluted in saline (HD, NDD); 300 mg infused over 1.5 hours, 400 mg over 2.5 hours 14 days later, 400 mg infused over 2.5 hours 14 days later (PD) | 7-day stability; anaphylactoid reactions |
| Ferumoxytol | Feraheme (AMAG) | 2009 | No | 510 mg × 2 doses separated by 3 or 8 days | IV infusion diluted in saline or Dextrose Injection over 15+ minutes | MRI interaction for up to 3 mo; resuscitation equipment and trained personnel necessary. Anaphylactic-type reactions presenting with cardiac/cardiorespiratory arrest, clinically significant hypotension, syncope, and unresponsiveness |
| Ferric carboxymaltose | Injectafer (American Reagent) | 2013 | No | 750 mg × 2 doses separated by at least 7 days (weighing ≥110 lb); 15 mg/kg body weight separated by at Least 7 days (weighing <110 lb) | Undiluted IV push at 100 (2mL) per minute, or diluted infusion over at least 15 minutes | Anaphylactic-type reactions presenting with shock, clinically significant hypotension, loss of consciousness, and/or collapse |
Note: IV= intravenous; HD=hemodialysis; NDD=Non-hemodialysis dependent; PD=peritoneal dialysis