Names and pronunciation
Monofferic
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Drug reference
Monofferic
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Func. class.: Hematinic
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Chem. class.: Iron preparation
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ACTION: Releases iron stores needed for red blood cell development as well as energy and O2 transport and use
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USES: Iron-deficiency anemia in those intoler- ant to PO iron and those with kidney disease not on dialysis
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CONTRAINDICATIONS Hemosiderosis/hemochromatosis Precautions: Pregnancy, anemia, hepatic disease, vitamin D deficiency, hemoglobinopathy, hyperparathyroidism, hypophosphatemia
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SIDE EFFECTS GI: Nausea, constipation, vomiting CNS: Dizziness, headache, chills, syncope CV: Hyper/hypotension, flushing, tachy- cardia, chest pain INTEG: Pruritus, injection site color change, rash
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INTERACTIONS Increase: nephrotoxicity—dimercaprol Drug/Lab Test. Increase: LFTs GGT False positive: Serum iron within 24 hr after use
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DOSAGE AND ROUTES Ferric carboxymaltose • Adult ≥50 kg: IV 750 mg on day 1, repeat after ≥7 days, may repeat if needed; <50 kg: IV 15 mg/kg on day 1, repeat after ≥7 days; max cumulative dose 1500 mg per course of treatment
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Available forms: Injection 750 mg of elemental iron in 15-mL, single-dose vial Ferric derisomaltose • Adult: IV infusion ≥50 kg:1000 mg as a single dose. Repeat dose if iron-defi- ciency recurs; ≤50 kg: 20 mg/kg/dose as a single dose. Repeat dose if iron-defi- ciency recurs
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Administer: Ferric carboxymaltose • Visually inspect for particulate matter and discoloration prior to use • Give as an undiluted slow IV push or by continuous IV infusion • Each vial is for single use only. Discard any unused portions; contains no preser- vatives F • Avoid extravasation since brown dis- coloration of the extravasation site may be long lasting. If extravasation occurs, discontinue administration at that site IV Push • No dilution necessary. Administer at a rate of approximately 2 mL/min (100 mg/min) Intermittent IV Infusion • Dilute up to 750 mg of iron in a maxi- mum of 250 mL of sterile 0.9% NaCl and infuse over at least 15 min. Do not dilute to concentrations less than 2 mg iron/mL in order to maintain stability • Store at room temperature for 72 hr when added to an infusion bag contain- ing 0.9% NaCl at concentrations ranging from 2 to 4 mg of iron per mL Ferric derisomaltose IV Infusion Route • Visually inspect parenteral products for particulate matter and discoloration prior to use • Withdraw appropriate volume of ferric derisomaltose and dilute in 100-500 mL of 0.9% NaCl injection. The final diluted concentration should be more than 1 mg/mL • Each vial of ferric derisomaltose is for single dose only; discard unused portion • Do not admix • Storage: Following dilution in 0.9% NaCl injection, ferric derisomaltose may be stored at room temperature for up to 8 hr • Give via IV infusion over 20 min
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Assess: • Blood studies: Hct, HB, serum phos- phate, before treatment; iron studies (iron, transferrin, ferritin) • Elimination: If constipation occurs, increase water, bulk, activity • Nutrition: Amount of iron in diet (meat, dark green leafy vegetables, dried beans, dried fruits, eggs) • Hypersensitivity: Assess allergic reaction to IV iron, usually within 30 min of injection, have emergency equipment available • Extravasation: Check for injection site reactions during treatment • Pregnancy/breastfeeding: No well- controlled studies; use only if benefits outweigh fetal risk; excreted in breast milk
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Evaluate: • Therapeutic response: improvement in Hct, HB, decreased fatigue, weakness
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • Not to take PO iron with this product • To report signs of hypersensitivity
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PHARMACOKINETICS IV: Onset unknown, peak 15 min-1.2 hr, duration unknown
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• Adult ≥50 kg: IV 750 mg on day 1, repeat after ≥7 days, may repeat if needed; <50 kg: IV 15 mg/kg on day 1, repeat after ≥7 days; max cumulative dose 1500 mg per course of treatment
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