Ferinject
Generic Name
Ferric Carboxymaltose
Manufacturer
Vifor Pharma (original), various licensees globally
Country
Switzerland (originator), various countries for production
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ferinject 100 mg injection | ৳ 996.74 | N/A |
Description
Overview of the medicine
Ferinject (Ferric Carboxymaltose) is an intravenous iron preparation used for the treatment of iron deficiency in adults when oral iron preparations are ineffective or cannot be used, or when there is a clinical need for rapid iron replenishment.
Uses & Indications
Dosage
Adults
Dosage is individualized based on total iron deficit. Common cumulative doses are 1000 mg elemental iron, administered as a single infusion or two infusions (e.g., 500 mg each). Maximum cumulative dose should not exceed 1000 mg iron per week.
Elderly
No specific dose adjustment is generally required, but caution should be exercised and overall health status should be considered.
Renal_impairment
No dose adjustment is typically required for patients with non-dialysis dependent CKD. For dialysis patients, consult specific guidelines or a physician.
How to Take
Administer intravenously only, by infusion or slow injection. For infusion, dilute in sterile 0.9% sodium chloride solution. Infusion rates vary by dose (e.g., 500 mg over 15 minutes, 1000 mg over 30 minutes). Do not administer concomitantly with oral iron preparations.
Mechanism of Action
Ferric carboxymaltose is a complex of iron(III) hydroxide and carbohydrate. Following intravenous administration, the iron complex is taken up by the reticuloendothelial system (RES), where iron is slowly released and then incorporated into hemoglobin, myoglobin, and other iron-containing enzymes, or stored as ferritin.
Pharmacokinetics
Onset
Hemoglobin increase is typically observed within 1-2 weeks; full therapeutic effect may take several weeks.
Excretion
Mainly through the reticuloendothelial system. Very little intact ferric carboxymaltose is excreted via the kidneys.
Half life
The elimination half-life for total iron is approximately 7-12 hours.
Absorption
Rapid uptake by the reticuloendothelial system. Peak serum iron levels are observed shortly after infusion, followed by a gradual decline as iron is utilized and stored.
Metabolism
The carbohydrate shell of ferric carboxymaltose is metabolized. The iron released from the complex is then incorporated into physiological iron pathways.
Side Effects
Contraindications
- Hypersensitivity to ferric carboxymaltose or any of the excipients of Ferinject.
- Anemia not attributed to iron deficiency (e.g., hemolytic anemia).
- Evidence of iron overload or disturbances in iron utilization (e.g., hemochromatosis).
- First trimester of pregnancy (due to limited safety data).
Drug Interactions
ACE Inhibitors
No specific direct interaction, but general caution for patients with a history of hypersensitivity to other agents, as they may also be predisposed to reactions with IV iron.
Oral Iron Preparations
Concomitant administration of Ferinject with oral iron preparations may reduce the absorption of oral iron. Oral iron therapy should not be started for at least 5 days after the last Ferinject administration.
Storage
Store below 30°C. Do not freeze. Keep the vial in the outer carton to protect from light. Once diluted, the solution should be used immediately.
Overdose
Overdose can lead to iron overload, which may present as hemochromatosis. Treatment of overdose should be managed by a healthcare professional and may include supportive care or iron chelating agents if clinically severe. Monitor serum ferritin and transferrin saturation.
Pregnancy & Lactation
Pregnancy Category B. Ferinject should be used during pregnancy only if clearly needed and after the first trimester. Limited data suggests minimal transfer into breast milk; caution is advised when administering to a nursing mother. Consult a physician before use.
Side Effects
Contraindications
- Hypersensitivity to ferric carboxymaltose or any of the excipients of Ferinject.
- Anemia not attributed to iron deficiency (e.g., hemolytic anemia).
- Evidence of iron overload or disturbances in iron utilization (e.g., hemochromatosis).
- First trimester of pregnancy (due to limited safety data).
Drug Interactions
ACE Inhibitors
No specific direct interaction, but general caution for patients with a history of hypersensitivity to other agents, as they may also be predisposed to reactions with IV iron.
Oral Iron Preparations
Concomitant administration of Ferinject with oral iron preparations may reduce the absorption of oral iron. Oral iron therapy should not be started for at least 5 days after the last Ferinject administration.
Storage
Store below 30°C. Do not freeze. Keep the vial in the outer carton to protect from light. Once diluted, the solution should be used immediately.
Overdose
Overdose can lead to iron overload, which may present as hemochromatosis. Treatment of overdose should be managed by a healthcare professional and may include supportive care or iron chelating agents if clinically severe. Monitor serum ferritin and transferrin saturation.
Pregnancy & Lactation
Pregnancy Category B. Ferinject should be used during pregnancy only if clearly needed and after the first trimester. Limited data suggests minimal transfer into breast milk; caution is advised when administering to a nursing mother. Consult a physician before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 3 years from manufacture date when stored correctly. Refer to the product's outer carton for exact expiry.
Availability
Hospitals, Clinics, Specialized pharmacies
Approval Status
Approved by major regulatory bodies globally (e.g., FDA, EMA, DGDA)
Patent Status
Patent protected (original formulation by Vifor Pharma)
Clinical Trials
Extensive clinical trials (e.g., FERGILE, FIND-CKD, PADA-RCT, REVOKE) have confirmed the efficacy and safety of Ferric Carboxymaltose in various indications including iron deficiency anemia in CKD, IBD, and post-partum settings.
Lab Monitoring
- Complete blood count (CBC) with hemoglobin levels
- Serum ferritin
- Transferrin saturation (TSAT)
- Iron studies (e.g., total iron binding capacity)
Doctor Notes
- Always assess the patient's full iron status (Hb, ferritin, TSAT) before starting and throughout treatment.
- Monitor patients closely for signs of hypersensitivity for at least 30 minutes after each infusion.
- Ensure appropriate resuscitation measures are immediately available in case of a severe allergic reaction.
Patient Guidelines
- Immediately report any signs of an allergic reaction (e.g., difficulty breathing, rash, swelling of face/throat, chest tightness) during or after the infusion.
- Inform your doctor about all current medications, including over-the-counter drugs, supplements, and herbal remedies.
- Follow up with your doctor for scheduled blood tests to monitor iron levels and treatment response.
- Do not take oral iron supplements unless specifically instructed by your doctor, especially within 5 days of Ferinject administration.
Missed Dose Advice
Ferinject is administered by a healthcare professional in a clinical setting. If a scheduled dose or appointment is missed, contact your doctor or clinic immediately to reschedule.
Driving Precautions
Ferinject may cause dizziness or lightheadedness. Patients should be cautioned against driving or operating machinery until they are certain that Ferinject does not adversely affect their ability to perform such tasks.
Lifestyle Advice
- Maintain a balanced diet to support overall health, but note that Ferinject addresses severe iron deficiency requiring intravenous therapy.
- Regular exercise and adequate sleep can help manage fatigue associated with anemia and improve overall well-being.
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