What are the brand‑name iron preparations (including their generic names) for oral and intravenous therapy?

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Brand-Name Iron Preparations

The most commonly available brand-name iron preparations include oral formulations such as ferrous sulfate (generic), ferrous fumarate (Ferro-Sequels, Ferretts), and ferrous gluconate (Fergon), along with newer agents like ferric citrate (Auryxia), ferric maltol (Feraccru/Accrufer), and liposomal iron (Ferrolip, SiderAL Forte); for intravenous therapy, key formulations include iron sucrose (Venofer), ferric carboxymaltose (Ferinject/Injectafer), ferric derisomaltose (Monofer/Monoferric), ferumoxytol (Rienso/Feraheme), sodium ferric gluconate (Ferrlecit), and low-molecular-weight iron dextran (Cosmofer/INFeD). 1, 2, 1, 3

Oral Iron Preparations

Traditional Ferrous Salts

  • Ferrous sulfate (generic): 65 mg elemental iron per 325 mg tablet, remains the gold standard and most cost-effective option at $0.30-$4.50 per 30 pills 2, 3, 4
  • Ferrous fumarate (Ferro-Sequels, Ferretts, Ferrimin, Hemocyte): 106-150 mg elemental iron per tablet, approximately $3.90 per 30 pills 1, 3
  • Ferrous gluconate (Fergon, Ferate): 27-38 mg elemental iron per tablet, $1.50-$3.30 per 30 pills 2, 1, 3

Newer Oral Formulations

  • Ferric citrate (Auryxia [USA], Riona [Japan], Nephoxil [Taiwan]): 210 mg elemental iron per 1g tablet in US formulation; shown to increase hemoglobin while lowering phosphate and FGF23 levels 1
  • Ferric maltol (Feraccru [Europe], Accrufer [USA]): 30 mg elemental iron per capsule, lipophilic iron donor with potentially improved tolerability 1, 5
  • Liposomal iron (Ferrolip, SiderAL Forte [Europe]): 30 mg elemental iron per capsule, bypasses hepcidin-ferroportin block through M-cell uptake 1
  • Ferrous bisglycinate: 25 mg elemental iron per tablet, approximately $2.40 per 30 pills, associated with fewer GI complaints than conventional formulations 3, 6
  • Polysaccharide-iron complex: Variable iron content listed in product name, approximately $4.20 per 30 pills 3
  • Heme iron polypeptide (Proferrin [USA]): 12 mg elemental iron per tablet 1

Intravenous Iron Preparations

High-Dose Formulations (Allow Total Dose Infusion)

  • Ferric carboxymaltose (Ferinject [Europe], Injectafer [USA]): 50 mg/mL concentration, maximum single dose 1000 mg (EMA) or 750 mg (FDA), 15-minute infusion time, cost approximately $3,470 for typical dosing 1, 2, 3, 7

    • Critical caveat: Associated with hypophosphatemia risk, particularly with repeated dosing; avoid in patients requiring multiple infusions 3, 7, 8

  • Ferric derisomaltose/Iron isomaltoside (Monofer [Europe], Monoferric [USA]): 100 mg/mL concentration, maximum 20 mg/kg (EMA) or 1000 mg (FDA), only formulation with FDA-approved total dose infusion label, cost approximately $3,896 1, 7

  • Low-molecular-weight iron dextran (Cosmofer [Europe], INFeD [USA]): 50 mg/mL concentration, maximum 20 mg/kg, 4-6 hour total infusion time, cost approximately $405; can also be given intramuscularly though this is painful 1, 2, 3

    • Safety concern: Historical serious reaction rate 0.6-0.7% with 31 fatalities reported 1976-1996 2

  • Ferumoxytol (Rienso [Europe], Feraheme [USA]): 30 mg/mL concentration, 510-1020 mg dosing, 15-minute infusion, cost approximately $1,963 1, 3, 7

    • Unique consideration: Also used as MRI contrast agent; notify radiology if MRI requested within 3 months of infusion 3, 7
    • Generic warning: Sandoz generic formulation showed double the infusion reaction rate of brand with one reported death; exercise caution 7

Lower-Dose Formulations (Require Multiple Administrations)

  • Iron sucrose (Venofer); Iron sucrose similars (FerMed): 20 mg/mL concentration, maximum 200 mg single dose, 500 mg weekly maximum, 10-30 minute infusion, cost approximately $441.50 for typical course 1, 2, 3

    • Note: Original formulation with 70+ years clinical experience; concerns exist about substituting with iron sucrose similars due to differences in physicochemical properties 9, 10

  • Sodium ferric gluconate (Ferrlecit): 12.5 mg/mL concentration, maximum 125 mg single dose, 60-minute infusion (FDA), cost approximately $610 for typical course 1, 3

  • Ferric pyrophosphate citrate: Recently FDA-approved at time of 2021 KDIGO guidelines 1

Key Clinical Considerations

Oral iron dosing: Effective repletion requires 100-200 mg elemental iron daily for 3-12 weeks, continued for 3 months after correction to replenish stores 2, 4. Lower doses may be equally effective with better tolerability 2.

IV iron safety: All formulations carry <1% risk of moderate-to-severe infusion reactions; resuscitation facilities must be available 2, 7, 8. Avoid diphenhydramine for reactions as side effects can mimic worsening symptoms 3.

Monitoring after IV iron: Check CBC and iron parameters (ferritin, TSAT) 4-8 weeks after last infusion; avoid testing within 4 weeks as circulating iron interferes with assays 7. Monitor phosphate levels, especially with ferric carboxymaltose 1, 3, 8.

References

4
Research

Oral and Intravenous Iron Therapy.

Advances in experimental medicine and biology, 2025

8
Research

Intravenous iron supplementation therapy.

Molecular aspects of medicine, 2020

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