Can FCM Injection Cause Facial Hyperpigmentation?
No, ferric carboxymaltose (FCM) injections do not cause facial hyperpigmentation, but they can cause localized skin staining or discoloration specifically at the infusion site if extravasation occurs. 1
Understanding FCM-Related Skin Discoloration
The key distinction is that FCM causes local injection site reactions, not systemic facial hyperpigmentation:
- Skin staining occurs only at the infusion site when there is paravenous leakage (extravasation) of the IV iron during administration 1
- This is a localized complication, not a systemic effect that would affect distant sites like the face 1
- The discoloration is preventable through proper IV line placement and care 1
Prevention of Skin Staining
To avoid this complication entirely:
- Ensure best practice in IV line placement and secure venous access before administering FCM 1
- Stop administration immediately if any signs of paravenous leakage occur 1
- Monitor the infusion site throughout the administration period 1
Common Side Effects of FCM
The most frequently reported side effects (occurring in 1-10% of patients) include 1:
- Dizziness
- Headache
- Hypertension
- Hypophosphatemia
- Injection-site reactions
- Nausea
Notably absent from this list is any mention of facial or systemic hyperpigmentation 1
Clinical Context
FCM has demonstrated an acceptable safety profile in clinical trials and post-marketing surveillance for patients with chronic heart failure and iron deficiency 1. The risk of hypersensitivity reactions is low (0.1-1%), and when skin changes occur, they are confined to the injection site and related to extravasation 1.
If facial hyperpigmentation develops in a patient receiving FCM, investigate alternative causes such as other medications, endocrine disorders, or idiopathic hyperpigmentation rather than attributing it to the FCM itself 2.