FCM Dose Calculation for Hb 7.2 g/dL, Weight 60 kg
For a patient with hemoglobin 7.2 g/dL and body weight 60 kg, the recommended total ferric carboxymaltose (FCM) dose is 1500 mg, based on ECCO guidelines for patients with Hb 70-100 g/L and body weight <70 kg. 1, 2
Dose Calculation Algorithm
For patients with severe anemia (Hb 7.0-10.0 g/dL):
Your patient falls into the first category (60 kg, Hb 7.2 g/dL = 72 g/L), requiring 1500 mg total FCM dose. 1, 2
Administration Considerations
Intravenous iron is strongly indicated as first-line therapy in this patient because:
- Hemoglobin is below 10 g/dL (100 g/L), which is a specific indication for IV iron over oral iron 1, 2, 3
- IV iron demonstrates superior efficacy, faster response, and better tolerability compared to oral iron in patients with severe anemia 1, 2
- Expected hemoglobin increase with IV iron is 7-10 g/L compared to only 4-7 g/L with oral iron 2
Dosing Schedule Options
The 1500 mg total dose can be administered as:
- Single infusion of 1500 mg FCM (if using high-dose formulation) 2
- Two infusions of 750 mg FCM separated by at least 7 days 2
- Three infusions of 500 mg FCM given weekly 2
The specific schedule depends on your institution's protocol and the FCM formulation available, but the total cumulative dose should be 1500 mg. 1, 2
Critical Pitfall to Avoid
Do not delay IV iron administration while waiting for complete iron studies in a patient with Hb 7.2 g/dL. 2, 3 While confirming iron deficiency with ferritin and transferrin saturation is ideal, the severity of anemia (Hb <10 g/dL) itself justifies empiric IV iron therapy, and you can obtain iron studies before the first infusion without delaying treatment. 2, 3