GI disorders associated with malabsorption of fat-soluble vitamins or phosphate, concurrent/prior use of medications that affect proximal renal tubular function, hyperparathyroidism, vitamin D deficiency, or malnutrition (↑ risk of hypophosphatemia)
OB: Severe hypersensitivity reactions may occur that can lead to bradycardia in fetus, especially during 2nd and 3rd trimesters
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children <1 yr (safety and effectiveness not established);
Geri: Older adults may be more sensitive to effects.
IV (Adults and Children ≥1 yr and ≥50 kg): 750 mg, followed at least 7 days later by a second dose of 750 mg (total cumulative dose = 1500 mg/course) OR 15 mg/kg (max dose = 1000 mg) as a single dose.
IV (Adults and Children ≥1 yr and <50 kg): 15 mg/kg, followed at least 7 days later by a second dose of 15 mg/kg.
Monitor for signs and symptoms of hypersensitivity reactions (hypotension, loss of consciousness, pruritus, rash, urticaria, wheezing) for at least 30 min and stable following completion of injection.
Monitor for injection site for extravasation. May cause long lasting brown discoloration at site. If extravasation occurs, discontinue and administer at another site.
Monitor BP during infusion. May cause transient hypertension. May cause facial flushing, dizziness and nausea. Usually resolved within 30 min following injection.
Lab Test Considerations:
Monitor hemoglobin, serum ferritin, and transferrin saturation prior to and at completion of course of therapy.
Monitor serum phosphate in patients at risk for low phosphate who require a repeat course of therapy.
Intermittent Infusion: Dilution: Dilute 750 mg of iron in not >250 mL of 0.9% NaCl. Concentration: Not <2 mg of iron/mL.Solution should be clear; avoid using solutions that contain particulate matter.
Explain purpose of ferric carboxymaltose to patient. Ask patient if they have a history of reactions to parenteral iron products. Advise patient to read Patient Information before starting and periodically during therapy in case of changes.
Advise patient to notify health care professional if signs and symptoms of hypersensitivity reaction occurs.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications. Instruct patient to avoid taking iron supplements during therapy.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Severe maternal reactions (circulatory failure, severe hypotension, shock, anaphylaxis) may occur increasing risk for preterm delivery and low birth weight. May cause fetal bradycardia, especially in 2nd and 3rd trimester. Monitor breastfed infants for GI toxicity (constipation, diarrhea).