What is the appropriate dosing of Feraheme (ferumoxytol) for a patient with chronic anemia, severely low iron saturation, and hypoferritinemia requiring intravenous iron supplementation?

From the Guidelines

Feraheme (ferumoxytol) should be administered as an intravenous infusion of 1020 mg in a single dose, diluted in 100 mL of normal saline and infused over 30 minutes, for patients with chronic anemia and low iron saturation with low ferritin levels, as this dosing regimen has been shown to be safe and effective 1. The dosing of feraheme is crucial in managing iron deficiency anemia, and recent guidelines suggest that a single dose of 1020 mg is a viable option, with no serious adverse events reported 1.

• Key considerations for administration include:
  • Dilution in 100 mL of normal saline
  • Infusion over 30 minutes
  • Monitoring for hypersensitivity reactions
  • Administration in a setting with equipment and personnel available to manage reactions The medication works by releasing iron from the carbohydrate complex, allowing it to be incorporated into hemoglobin and stored as ferritin, effectively addressing both the anemia and depleted iron stores.
• Benefits of this dosing regimen include:
  • Rapid replenishment of iron stores
  • Improved hemoglobin concentrations
  • Reduced need for multiple infusions
  • Simplified administration process It is essential to note that feraheme is particularly useful in patients with chronic kidney disease but can be used in other causes of iron deficiency anemia, and its administration should be tailored to the individual patient's needs, with careful monitoring of vital signs during and after the infusion 1.

From the FDA Drug Label

The recommended dose of Feraheme is an initial 510 mg dose followed by a second 510 mg dose 3 to 8 days later. Administer Feraheme as an intravenous infusion in 50-200 mL 0. 9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP over at least 15 minutes.

The appropriate dosing for a patient with chronic anemia and very low iron saturation with low ferritin levels who needs an iron transfusion of Feraheme is an initial 510 mg dose followed by a second 510 mg dose 3 to 8 days later. The dose should be administered as an intravenous infusion over at least 15 minutes. 2

From the Research

Iron Deficiency Anemia Treatment

The patient has chronic anemia with very low iron saturation and low ferritin levels, indicating a need for iron transfusion. Feraheme is an intravenous iron replacement therapy.

Appropriate Dosing

• The provided studies do not specifically mention Feraheme dosing for the patient's condition 3, 4, 5, 6, 7.
• However, the studies discuss the use of intravenous iron, such as ferumoxytol, for treating iron deficiency anemia in patients with chronic kidney disease 4, 5, 6.
• According to the studies, ferumoxytol can be administered in doses up to 510 mg as a rapid injection, with some studies using two injections of 510 mg within 7 days 4, 5.
• The National Institute for Health and Care Excellence (NICE) guideline recommendations suggest using high-dose low-frequency administration of intravenous iron, but do not specify the exact dosing for Feraheme 7.

Considerations

• The patient's iron deficiency anemia diagnosis is based on low serum ferritin and transferrin saturation levels 3.
• Intravenous iron is indicated for patients with oral iron intolerance, poor absorption, chronic inflammatory conditions, ongoing blood loss, and during the second and third trimesters of pregnancy 3.
• The choice of intravenous iron and dosing should be based on the patient's specific condition, medical history, and response to treatment.