Newer formulations of intravenous iron: a review of their chemistry and key safety aspects - hypersensitivity, hypophosphatemia, and cardiovascular safety

  • Introduction: The newest intravenous (IV) iron products show an improved safety profile over predecessors, allowing for the rapid administration of relatively high doses. Ferric derisomaltose (FDI; also known as iron isomaltoside), ferric carboxymaltose (FCM), and ferumoxytol (FER), are successful treatments for iron deficiency (Europe; FDI and FCM) and iron deficiency anemia (US; FDI, FCM, and FER). Areas covered: This review focusses on the chemistry and structure of FDI, FCM, and FER, and on three key aspects of IV iron safety: (1) hypersensitivity; (2) hypophosphatemia and sequelae; (3) cardiovascular safety. Expert opinion: Although the safety of modern IV iron has improved, immediate infusion reactions and the development of hypophosphatemia must be appreciated and recognized by those who prescribe and administer IV iron. Immediate infusion reactions can occur with any IV iron and are usually mild; severe reactions – particularly anaphylaxis – are extremely rare. The recognition and appropriate management of infusion reactions is an important consideration to the successful administration of IV iron. Severe, persistent, hypophosphatemia is a specific side effect of FCM. No cardiovascular safety signal has been identified for IV iron. Ongoing trials in heart failure will provide additional long-term efficacy and safety data.
Author:Irina Ursula BlumensteinORCiDGND, Satish Shanbhag, Peter Langguth, Philip A. Kalra, Heinz Zoller, Wendy Lim
Parent Title (English):Expert opinion on drug safety
Publisher:Routledge, Taylor & Francis
Place of publication:Abingdon, Oxon
Document Type:Article
Date of Publication (online):2021/05/15
Date of first Publication:2021/05/15
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/03/01
Tag:Anemia; ferric carboxymaltose; ferric derisomaltose; ferumoxytol; heart failure; hypersensitivity; hypophosphatemia; intravenous iron; iron deficiency; iron isomaltoside
Page Number:13
First Page:757
Last Page:769
This work was supported by Pharmacosmos A/S, Holbæk, Denmark.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0