Dosing and Administration
Dosing
Dosing based on your patients' specific iron needs. >>
Please see other Important Safety Information and the Feraheme full Prescribing Information below.
Feraheme is an IV iron approved for the treatment of iron deficiency anemia (IDA) in adult patients with chronic kidney disease (CKD). Feraheme offers a number of distinct dosing characteristics:
- 510-mg undiluted IV push that may be delivered in under 1 minute1
- Allows for goal-directed dosing
- Deliver at a rate of up to 1 mL/sec (30 mg/sec)1
- Second dose should be delivered 3 to 8 days after the first dose1
- Treatment with fewer injections over a shorter period of time compared to other IV irons1,3-5
- 1 gram of elemental iron may be provided with 2 treatments of 510 mg1
- The recommended Feraheme dose may be readministered as needed to CKD patients with persistent or recurrent IDA1
- No test dose or dilution necessary1
Additional considerations
- Evaluate the hematologic response (hemoglobin [Hgb], ferritin, iron, and transferrin saturation [TSAT]) at least 1 month following the second Feraheme injection1
- For patients receiving hemodialysis, administer Feraheme once blood pressure is stable and the patient has completed at least 1 hour of hemodialysis1
- Monitor for signs and symptoms of hypotension following each Feraheme injection1
- Do not administer to patients with iron overload1
- Patients should be observed for signs and symptoms of hypersensitivity for at least 30 minutes following Feraheme injection
- Feraheme should only be administered when personnel and therapies are readily available for the treatment of hypersensitivity reactions
- No head-to-head studies against other IV irons have been conducted
Feraheme dosing
One regimen across the spectrum of CKD
Click on sections of the table below to review the dosing and rate of administration of Feraheme and the dosing and administration of other available IV irons. Please note no head-to-head comparator trials comparing the IV irons listed here have been conducted. Please see full Prescribing Information of each IV iron listed for more details.
Feraheme and other available IV irons
| Feraheme1,2 (30 mg Fe/mL) fewer injections over a shorter period of time |
Venofer®3 (100 mg Fe/5 mL) (200 mg Fe/10 mL) |
|
|---|---|---|
| Indication | Treatment of iron deficiency anemia in adult patients with chronic kidney disease (CKD) |
Treatment of iron deficiency anemia in the following patients:
|
| Dose and rate of administration |
||
| NDD-CKD | 510-mg dose administered as a rapid IV push in under 1 minute; second dose should be delivered 3 to 8 days after the first dose (2 x 510-mg treatments within 1 week) |
Five 200-mg (10-mL) treatments administered by slow IV injection (2–5 min) over 14 days. There is limited experience administering 500 mg (25 mL) diluted in ≤250 mL 0.9% NaCl, by slow infusion (3.5–4 hrs) on Day 1 and Day 14; hypotension occurred in 2 of 30 patients treated |
| DD-CKD | Same as above | Ten 100-mg (5-mL) treatments administered by slow IV injection (2–5 min); or 100 mg (5 mL) diluted in ≤100 mL 0.9% NaCl by IV infusion (≥15 min) in consecutive dialysis sessions |
| PDD-CKD | Same as above | Two 300-mg (15-mL) treatments diluted in ≤250 mL 0.9% NaCl administered by slow IV infusion (1.5 hrs) 14 days apart, followed by one 400-mg (20-mL) treatment (same dilution) by slow infusion (2.5 hrs) 14 days later |
| Time to complete administration of 1 gram | Within 1 week | 14–28 days |
| Feraheme1,2 (30 mg Fe/mL) fewer injections over a shorter period of time |
Ferrlecit®4 (62.5 mg Fe/5 mL) |
|
|---|---|---|
| Indication | Treatment of iron deficiency anemia in adult patients with chronic kidney disease (CKD) |
Treatment of iron deficiency anemia in adult patients and in pediatric patients age 6 years and older undergoing chronic hemodialysis who are receiving supplemental epoetin therapy |
| Dose and rate of administration |
||
| NDD-CKD | 510-mg dose administered as a rapid IV push in under 1 minute; second dose should be delivered 3 to 8 days after the first dose (2 x 510-mg treatments within 1 week) |
Not indicated |
| DD-CKD | Same as above | 125-mg (10-mL) treatments diluted in 100 mL 0.9% NaCl administered by slow IV over 1 hr; or 10 mL undiluted by slow IV injection at a rate of up to 1 mL/min Most patients will require a minimum cumulative dose of 1.0 gram of elemental iron, administered over 8 sessions to achieve a favorable hemoglobin or hematocrit response |
| PDD-CKD | Same as above | Not indicated |
| Time to complete administration of 1 gram | Within 1 week | ≥16 days (assuming dialysis every other day) |
| Feraheme1,2 (30 mg Fe/mL) fewer injections over a shorter period of time |
INFeD®5 (50 mg Fe/mL) |
|
|---|---|---|
| Indication | Treatment of iron deficiency anemia in adult patients with chronic kidney disease (CKD)
|
Treatment of patients with documented iron deficiency in whom oral administration is unsatisfactory or impossible |
| Dose and rate of administration |
||
| NDD-CKD | 510-mg dose administered as a rapid IV push in under 1 minute; second dose should be delivered 3 to 8 days after the first dose (2 x 510-mg treatments within 1 week) |
PRIOR TO RECEIVING THEIR FIRST INFeD THERAPEUTIC DOSE, ALL PATIENTS SHOULD BE GIVEN AN INTRAVENOUS TEST DOSE OF 0.5 mL. THE TEST DOSE SHOULD BE ADMINISTERED AT A GRADUAL RATE OVER AT LEAST 30 SECONDS. Although anaphylactic reactions known to occur following INFeD administration are usually evident within a few minutes, or sooner, it is recommended that a period of an hour or longer elapse before the remainder of the initial therapeutic dose is given After waiting ≥1 hr after the test dose, all subsequent daily doses should be given until the calculated total amount required has been reached Treatments administered either as ≤100 mg (2 mL) undiluted by slow IV infusion not to exceed 1 mL/min, or intramuscularly (IM) at doses of ≤25 mg (.5 mL) for infants under 5 kg (11 lbs); ≤50 mg (1 mL) for children under 10 kg (22 lbs); or ≤100 mg (2 mL) for other patients |
| DD-CKD | Same as above | Same as above |
| PDD-CKD | Same as above | Same as above |
| Time to complete administration of 1 gram | Within 1 week | ≥10 days |
Venofer is a registered trademark of American Regent, Inc.
Ferrlecit and INFeD are registered trademarks of Watson Pharma, Inc.
