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IV iron

Ferric carboxymaltose

Brand names: Ferinject

Adult dose

Dose: Total replacement dose calculated by Hb and weight; max 1000mg per session over 15 min, max 20mg/kg
Route: IV infusion
Frequency: per dose

Clinical pearls

  • Rapid IV iron replacement
  • MHRA: hypophosphataemia may be prolonged — check phosphate before re-dosing

Contraindications

  • 1st trimester pregnancy
  • Iron overload
  • Anaemia not due to iron deficiency
  • History of severe hypersensitivity to IV iron

Side effects

  • Hypersensitivity (incl. anaphylaxis)
  • Hypophosphataemia (especially with repeated doses)
  • Headache
  • Hypotension
  • Skin staining at extravasation

Interactions

  • Oral iron (separate by ≥5 days post-IV)

Monitoring

  • Ferritin
  • TSAT
  • Hb
  • Phosphate (if symptomatic or repeat doses)

Reference: BNF; NICE NG8; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/ferric-carboxymaltose/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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