Intravenous Iron Formulations and Dosing

Available IV Iron Formulations

The American Gastroenterological Association recommends ferric carboxymaltose (Injectafer) 1000 mg as a single dose for patients ≥50 kg 1, 2
The American Gastroenterological Association recommends ferric derisomaltose (iron isomaltoside) 1000 mg IV over 15 minutes as single infusion 2
The National Comprehensive Cancer Network recommends low-molecular-weight iron dextran (INFed) 1000 mg IV over 1 hour as single total dose infusion, with a mandatory test dose of 25 mg slow IV push 3, 2
The American Gastroenterological Association recommends ferumoxytol 510 mg given as two doses, or 1020 mg as single dose, with special consideration for its use as an MRI contrast agent 2

The American Gastroenterological Association recommends choosing formulations allowing 1-2 total infusions to minimize patient burden and healthcare costs, unless specific contraindications exist 2

The National Comprehensive Cancer Network states that active infection is an absolute contraindication for IV iron administration 3, 4
The American Gastroenterological Association reports that hypersensitivity reactions occur in <1:200,000 administrations with modern formulations, and recommends observing patients for at least 30 minutes post-infusion 1, 2
The National Comprehensive Cancer Network recommends test doses for iron dextran, and strongly recommends them for ferric gluconate and iron sucrose in patients with previous sensitivities or multiple drug allergies 3, 4

The National Comprehensive Cancer Network recommends maintenance dosing of 250-1000 mg within 12-week periods for hemodialysis patients, with a target of transferrin saturation ≥20% and ferritin ≥100 ng/mL 4
The National Comprehensive Cancer Network recommends monitoring iron parameters every 3 months during maintenance for hemodialysis patients 4