title: The available intravenous iron formulations: History, efficacy, and toxicology.
abstract: A number of intravenous iron formulations have been developed over the past 65 years which rely on dextran or other compounds to prevent uncontrolled release of free iron to the circulation. High molecular weight dextran was associated with a number of serious adverse reactions and was removed from markets worldwide in 2009. The preponderance of published evidence suggests that the formulations of parenteral iron currently available in the United States, including low molecular weight iron dextran, are all safe and effective and there are no major, clinically important differences among them in terms of either efficacy or safety. For patients with chemotherapy induced anemia or with anemia of end stage renal disease who are being treated with hemodialysis, it is reasonable to use any of the iron formulations, including iron sucrose and ferric gluconate, as frequent patient encounters with health caregivers are a routine part of care and the need to administer multiple low doses of IV iron is not a major disadvantage. However, a single infusion of a total iron dose is as effective and safe when giving iron preparations containing low molecular weight iron dextran, ferumoxytol, iron isomaltoside, or ferric carboxymaltose. Use of a single total dose infusion results in a decreased number of intravenous infusions with a lower cumulative risk for infusion reactions or extravasations, a reduced need for multiple office visits and repeated utilization of medical staff, and increased convenience for physicians and patients.
authors.affiliation: Auerbach Hematology and Oncology, Private Practice, Rosedale, Maryland, USA.|Georgetown University School of Medicine, Washington, District of Columbia, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Auerbach
authors.affiliation: Renal Unit, King's College Hospital, London, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Macdougall
mesh_terms: D000740:Anemia / Q000188:drug therapy*; D004339:Drug Compounding; D005290:Ferric Compounds / Q000627:therapeutic use; D052203:Ferrosoferric Oxide / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000008:administration & dosage* / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008320:Maltose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006435:Renal Dialysis / Q000009:adverse effects
chemical_list: D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose; D007501:Iron; C035552:ferric gluconate; D052203:Ferrosoferric Oxide
keywords: Intravenous iron; chronic kidney disease; iron deficiency anemia