From the Guidelines
Intravenous (IV) iron therapy is contraindicated in patients with known hypersensitivity to any IV iron product or its components, as well as in those with iron overload conditions such as hemochromatosis or hemosiderosis, according to the most recent guidelines 1.
Key Contraindications and Precautions
- IV iron should not be administered during the first trimester of pregnancy, in patients with active acute infections, or in those with decompensated liver disease 1.
- Caution is required in patients with a history of significant allergies, asthma, eczema, or other atopic allergies due to increased risk of hypersensitivity reactions 1.
- Administration is not recommended during active bacteremia, as iron can serve as a growth factor for bacteria 1.
- Patients with severe renal impairment receiving hemodialysis require careful monitoring 1.
Important Considerations for Administration
- Each specific IV iron formulation may have additional unique contraindications, so checking the specific product information is essential 1.
- When administering IV iron, facilities must be equipped to manage potential anaphylactic reactions with appropriate resuscitation equipment and trained personnel immediately available, as severe hypersensitivity reactions, though rare, can occur rapidly after administration 1.
Recent Guidelines and Recommendations
- The most recent guidelines recommend the use of IV iron in patients who cannot tolerate oral iron or in whom oral iron supplementation is not effective 1.
- IV iron formulations that can replace iron deficits with 1 to 2 infusions are preferred due to their convenience and similar efficacy and risk profiles 1.
From the FDA Drug Label
Injectafer is contraindicated in patients with a history of hypersensitivity to Injectafer or any of its components [see Warnings and Precautions (5.1)]. Hypersensitivity to Injectafer or any of its inactive components (4)
The contraindications for IV iron (ferric carboxymaltose) are:
- Hypersensitivity to Injectafer or any of its components 2
- Hypersensitivity to Injectafer or any of its inactive components 2
From the Research
Iv Iron Contraindications
- Haemochromatosis is a condition that can lead to iron overload, and IV iron may be contraindicated in patients with this condition 3, 4, 5, 6
- Patients with a history of hemosiderosis or hemochromatosis may be at risk of iron overload with IV iron therapy 7
- Conditions that may increase the risk of iron overload, such as obesity and alcohol consumption, may also be contraindications for IV iron therapy 4
- Genetic testing for HFE mutations, such as the C282Y mutation, may be necessary to determine the risk of iron overload in patients considering IV iron therapy 3, 4, 5
- Patients with advanced organ damage, such as liver or heart disease, may be at increased risk of complications from IV iron therapy 4, 6