From the FDA Drug Label
2 DOSAGE AND ADMINISTRATION
- 1 Recommended Dosage Recommended Dosage for Treatment of Iron Deficiency Anemia For patients weighing 50 kg or more, the recommended dosage is: Injectafer 750 mg intravenously in two doses separated by at least 7 days for a total cumulative dose of 1,500 mg of iron per course In adult patients, Injectafer 15 mg/kg body weight up to a maximum of 1,000 mg intravenously may be administered as a single-dose per course. For patients weighing less than 50 kg, the recommended dosage is Injectafer 15 mg/kg body weight intravenously in two doses separated by at least 7 days per course
The recommended dosing regimen for intravenous (IV) iron in pregnant women with iron deficiency anemia is:
- For patients weighing 50 kg or more: 750 mg intravenously in two doses separated by at least 7 days for a total cumulative dose of 1,500 mg of iron per course
- For patients weighing less than 50 kg: 15 mg/kg body weight intravenously in two doses separated by at least 7 days per course
- Alternatively, for adult patients: 15 mg/kg body weight up to a maximum of 1,000 mg intravenously may be administered as a single-dose per course 1
From the Research
The recommended dosing regimen for intravenous (IV) iron in pregnant women with iron deficiency anemia is ferric carboxymaltose, given as 500-1000 mg per infusion, with a maximum of 1000 mg per week, usually requiring 1-2 infusions to complete treatment, as it is associated with fewer adverse events and a higher rise in hemoglobin compared to iron sucrose 2.
Key Considerations
- Before administration, calculate the total iron deficit based on pre-pregnancy weight and hemoglobin level.
- IV iron should be administered in a monitored setting due to the small risk of hypersensitivity reactions.
- Premedication is generally not required but should be available if needed.
- Treatment response should be assessed by checking hemoglobin levels 2-3 weeks after completion of the iron course.
Preferred Treatment
- IV iron is preferred over oral iron when rapid correction is needed, in cases of oral iron intolerance, or when hemoglobin is below 8-9 g/dL.
- This approach effectively replenishes iron stores more rapidly than oral supplementation, supporting both maternal health and fetal development during pregnancy.
Supporting Evidence
- A systematic review and meta-analysis published in 2024 found that ferric carboxymaltose is effective and safer than iron sucrose in treating iron deficiency anemia in pregnancy, with a higher rise in hemoglobin and fewer adverse events 2.
- Other studies have also highlighted the importance of iron supplementation in pregnancy, with oral iron being effective in preventing iron deficiency anemia, but with a higher risk of gastrointestinal side effects 3, 4.
- The use of IV iron has been shown to be effective in rapidly correcting iron deficiency anemia, with a lower risk of adverse events compared to oral iron 5, 6.