What are the dosing suggestions for Monoferric (ferric derisomaltose) for patients with iron deficiency anemia?

Monoferric (Ferric Derisomaltose) Dosing for Iron Deficiency Anemia

Ferric derisomaltose (Monoferric) should be administered as a single intravenous infusion of 1000 mg for most patients with iron deficiency anemia, which can effectively replenish iron stores in a single treatment session. 1

Dosing Guidelines

• The recommended dose of ferric derisomaltose is based on body weight and hemoglobin level: 2

  • For patients weighing <70 kg:
    • Hemoglobin 10-12 g/dL (women) or 10-13 g/dL (men): 1000 mg
    • Hemoglobin 7-10 g/dL: 1500 mg
  • For patients weighing ≥70 kg:
    • Hemoglobin 10-12 g/dL (women) or 10-13 g/dL (men): 1500 mg
    • Hemoglobin 7-10 g/dL: 2000 mg

• Ferric derisomaltose can be administered as a single high-dose infusion up to 1000 mg, making it more convenient than multiple smaller doses of other IV iron formulations 3, 4

• For patients with severe iron deficiency anemia, studies suggest that a cumulative dose of 1500 mg may be closer to the actual iron deficit than the standard 1000 mg dose 5

Administration Method

• Ferric derisomaltose should be administered as an intravenous infusion over 15-30 minutes 1

• No test dose is required before administration, unlike with iron dextran preparations 2, 3

• Resuscitation facilities should be available during administration due to the small risk of hypersensitivity reactions 2

Indications for IV Iron Therapy

• Intravenous iron therapy with ferric derisomaltose is indicated for patients with: 2
  • Intolerance to oral iron therapy
  • Inadequate response to oral iron therapy
  • Need for rapid iron repletion
  • Hemoglobin below 10 g/dL
  • Active inflammatory bowel disease
  • Chronic kidney disease with iron deficiency anemia

Monitoring and Follow-up

• After iron repletion, hemoglobin concentration and red cell indices should be monitored at 3-month intervals for the first year, then after another year 2

• Iron status should be re-evaluated 3 months after treatment, not earlier (especially within 4 weeks) as ferritin levels are markedly increased immediately following IV iron administration 2

• Additional iron repletion should be provided as needed based on follow-up testing 2

Safety Considerations

• Ferric derisomaltose has a favorable safety profile with a lower incidence of hypophosphatemia compared to some other IV iron formulations 4

• Cardiovascular adverse events may be less frequent with ferric derisomaltose compared to iron sucrose, which is particularly important for patients with heart failure 1, 6

• Contraindications include: 2

  • Hypersensitivity to the active substance or any excipients
  • Known serious hypersensitivity to other parenteral iron products
  • Anemia not attributed to iron deficiency
  • Evidence of iron overload or disturbances in iron utilization

Clinical Benefits

• Ferric derisomaltose provides a faster hematological response compared to multiple doses of iron sucrose 1

• In patients with heart failure and iron deficiency anemia, ferric derisomaltose improves quality of life and may decrease cardiovascular events 6

• The percentage of patients requiring retreatment is significantly lower with higher cumulative doses (1500 mg vs 1000 mg) 5

Practical Advantages

• Single-dose administration improves treatment compliance compared to multiple-dose regimens 3, 4

• The ability to administer a complete iron replacement dose in a single visit reduces healthcare resource utilization 1, 4