Ferric Carboxymaltose Dosing in Heart Failure with Anemia

Diagnostic Criteria for Iron Deficiency in Heart Failure

Iron deficiency is diagnosed when serum ferritin <100 μg/L, or serum ferritin 100-299 μg/L with transferrin saturation <20% 1, 2

Intravenous ferric carboxymaltose significantly improves exercise capacity (6-minute walk test distance) 3, 4, 5
Intravenous ferric carboxymaltose significantly improves NYHA functional class 3, 4, 5
Intravenous ferric carboxymaltose significantly improves quality of life measures 3, 4, 5
Intravenous ferric carboxymaltose significantly improves Patient Global Assessment scores 3, 4, 5
Intravenous ferric carboxymaltose may reduce heart failure hospitalizations 3, 2

Re-evaluate iron status 3 months after initial treatment 1
Avoid early re-evaluation (within 4 weeks) as ferritin levels are markedly elevated immediately following IV iron administration 1
Consider evaluating iron status 1-2 times per year in patients with chronic heart failure 1

Oral iron therapy has been shown ineffective in heart failure patients with iron deficiency (IRONOUT HF trial) 2
Contraindications include hypersensitivity to ferric carboxymaltose or its excipients 1
Contraindications include known serious hypersensitivity to other parenteral iron products 1
Contraindications include anemia not attributed to iron deficiency 1
Contraindications include evidence of iron overload 1
Use with caution in patients with acute or chronic infection (stop treatment in patients with bacteremia) 1
Use with caution in patients with known drug allergies, especially those with history of severe asthma, eczema, or atopic allergies 1
Use with caution in patients with immune or inflammatory conditions 1