Table 3.
Characteristic | Ferric carboxymaltose (Ferinject, Injectafer) 4, 5 | Ferumoxytol (Feraheme, Rienso) 6, 7 | Iron isomaltoside 1000 (Monofer, Monoferric) 8, 9 | Iron sucrose (Venofer) 10, 11, 12 | LMW iron dextran (CosmoFer, DexIron, INFeD) 13, 14, 15 | Sodium ferric gluconate (Ferrlecit) 16, 17 |
---|---|---|---|---|---|---|
Availability | Europe, USA | Europe, USA | Canada, Europe | Canada, Europe, USA | Canada, Europe, USA | Canada, USA |
Indicationa | Iron deficiency when oral iron cannot be used | Iron deficiency anaemia in adults with CKD | Iron deficiency anaemia when oral iron cannot be used (or rapid iron supply required – Europe only) | Iron deficiency in CKD (or when oral iron cannot be used or rapid iron supply required – Europe only) | Iron deficiency when oral iron cannot be used (or rapid iron supply required – Europe only) | Iron deficiency in haemodialysis patients receiving erythropoietin therapy |
Carbohydrate shell | Carboxymaltose | Polyglucose sorbitol | Isomaltoside | Sucrose | Dextran | Gluconate |
Molecular weight (kDa) | 150 | 750 | 150 | 43 | 400 | 289–440 |
Volume distribution (L) | 3 | 3·16 | N/A | ~3 | N/A | 6 |
Test dose required | No | No | No | No | In Canada/USA only | No |
Maximum single doseb | 750 mg (USA)1000 mg (Europe) | 510 mg | 1500 mg | 500 mg | 100 mg (Canada/USA)20 mg/kg (Europe) | 125 mg |
Infusion rate or timeb | ≥15 min | Injection at ≤1 ml/s (≤30 mg/s) | ≥15 min (≤1000 mg, Europe); ≥20 min (≤1000 mg, Canada); ≥30 min (>1000 mg) | 8 min (50 mg); 15 min (100 mg); 30 min (200 mg); 1·5 h (300 mg); 2·5 h (400 mg) | First 25 mg over15 min, remaining dose at < 100 ml/30 min; total dose infusion over 4–6 h | 1 h |
Specific indications vary across jurisdictions – refer to relevant product information. Off‐label use of certain products is not uncommon, but should be done in the context of full disclosure to the patient.
Maximum single dose and minimum infusion time as per product information, which may vary across jurisdictions.
CKD, chronic kidney disease; LMW, low molecular weight; N/A, information not available in product monograph; USA, United States of America.