Table 1.
Comparison of IV iron formulations.
IV iron product | Brand name | Standard label maximum single dose | Infusion time | Recommended doses | Risk and incidence of HSRs | Average wholesale price9 | Miscellaneous |
---|---|---|---|---|---|---|---|
Low molecular weight iron dextran | Cosmofer® INFeD® | 1000 mg | 4–6 h; 1-h infusion has also been described10 | Multiple doses of 100 mg or single dose of 1000 mg | Highest risk11 | $0.35/mg | Test dose required with 1-h observation period |
Any HSR: 4.7–5.6%12,13 | |||||||
Mod to severe HSR: 0.7%4 | |||||||
Ferric gluconate | Ferrlecit® | 125 mg | 60 min | Multiple doses | Low risk | $1.64/mg | |
Any HSR: 3.9%14 | |||||||
Mod to severe HSR: 0.4%14 | |||||||
Iron sucrose | Venofer® | 500 mg | 3.5–5 h | Multiple doses | Low risk | $0.60/mg | |
Any HSR: 5.0%15 | |||||||
Mod to severe HSRs: 0.4%16 | |||||||
Ferumoxytol | Feraheme ® Rienso® | 510 mg | 15 min | Two doses given 3–8 days apart | Low risk | $2.50/mg | MRI scans may appear contrast enhanced for up to 3 months following use18 |
Any HSR: 2.7%15 | |||||||
Mod to severe HSRs: 0.6%17 | |||||||
Ferric carboxymaltose (FCM) | Ferinject® Injectafer® | 750 mg for patients over 50 kg; 15 mg/kg for patients <50 kg | 15 min | Two doses given 7 or more days apart | Low risk | $1.82/mg | Hypophosphatemia is seen in 50% of patients and can persist five weeks or more20 |
Any HSR: 2.1%17,19 | |||||||
Mod to severe HSRs: 0.7% | |||||||
Ferric derisomaltose (formerly iron isomaltoside) | Monofer® Monoferric® | 20 mg/kg, not to exceed 1500 mg | 15–30 min | Single dose | Low to intermediate risk | Not available | Associated with fetal bradycardia following maternal administration21 |
Any HSR: 8.7% | |||||||
Mod to severe HSRs: 0.3–66.4%16,19 |
HSR, hypersensitivity reaction; IV, intravenous.