From the Guidelines
Ferric carboxymaltose should be administered as a single dose of up to 1,000 mg, with the option for a second dose after 7 days if needed, based on the patient's iron deficiency severity and body weight, as recommended by the most recent expert consensus guidelines 1. The frequency of administration depends on the patient's hemoglobin levels, iron stores (measured by ferritin and transferrin saturation), and underlying condition causing iron deficiency.
- For patients weighing less than 50 kg, the recommended dose is 20 mg/kg body weight.
- For maintenance therapy in conditions with ongoing blood loss like inflammatory bowel disease or heavy menstrual bleeding, FCM can be given every 3-6 months based on iron parameters monitoring. The medication is administered as an intravenous infusion over at least 15 minutes or as a slow IV push, with precautions to observe for acute onset of minor infusion reactions 1. Patients should be monitored for hypersensitivity reactions during and after administration, and iron parameters should be checked before repeated dosing to avoid iron overload, with a recommended re-evaluation of iron status at 3 months after IV administration of the correction dose 1. It is essential to note that FCM administration has been associated with treatment-emergent hypophosphatemia and should be avoided in patients who require repeat infusions 1.
From the FDA Drug Label
The safety and efficacy of Injectafer for treatment of IDA were evaluated in two randomized, open-label, controlled clinical trials (Trial 1 and Trial 2). In these two trials, Injectafer was administered at a dose of 15 mg/kg body weight up to a maximum single dose of 750 mg of iron on two occasions separated by at least 7 days up to a cumulative dose of 1,500 mg of iron
The frequency of administration of ferric carboxymaltose is every 7 days, with a maximum of two doses separated by at least 7 days, up to a cumulative dose of 1,500 mg of iron 2.
- The dose is 15 mg/kg body weight
- The maximum single dose is 750 mg of iron
- The cumulative dose is 1,500 mg of iron
From the Research
Administration Frequency of Ferric Carboxymaltose
- Ferric carboxymaltose can be administered intravenously, with a replenishment dose of up to 1000 mg of iron during a minimum administration time of ≤15 minutes 3.
- Repeated weekly administration of ferric carboxymaltose does not result in accumulation of transferrin iron in patients with iron-deficiency anaemia 3.
- The full dose of ferric carboxymaltose is two administrations of up to 750 mg separated by at least 7 days (up to 1500 mg total) 4.
- A single dose of ferric carboxymaltose may be given as an infusion over 6-15 minutes, with a maximum dose of 1000 mg (but not exceeding 15 mg/kg/week) 5.
- Ferric carboxymaltose can be injected in 7-8 min or diluted in saline for slower infusion 4.
Treatment Schedule
- Patients may receive ferric carboxymaltose equivalent to an iron dose of ≤1000 mg (or 15 mg/kg in those weighing <66 kg) administered over ≤15 minutes, with subsequent doses administered at 1-week intervals 3.
- Treatment with ferric carboxymaltose is typically continued until each patient has received their calculated total iron replacement dose 3.