ferumoxytol
Ferumoxytol (Feraheme) is an injectable medication that can raise iron levels in your body. It's used to treat iron deficiency anemia (IDA) in adults. Ferumoxytol (Feraheme) is given as an intravenous (IV) infusion by a healthcare provider. Common side effects of ferumoxytol (Feraheme) include headache, nausea, and dizziness. Rarely, it can cause serious allergic reactions, such as rash, itching, dizziness, and trouble breathing.
What is Ferumoxytol (Feraheme)?
What is Ferumoxytol (Feraheme) used for?
Treatment of iron deficiency anemia in:
Adults who can't take oral iron supplements
Adults who didn't see improvement in their iron levels after oral iron supplements
Adults with chronic kidney disease (CKD)
How Ferumoxytol (Feraheme) works
Ferumoxytol (Feraheme) is an iron replacement product. It's used to treat iron deficiency anemia. This condition happens when your body doesn't have enough iron to make red blood cells, which are used to carry oxygen around the body. Ferumoxytol (Feraheme) provides the body with more iron to make healthy red blood cells.
Drug Facts
What are the side effects of Ferumoxytol (Feraheme)?
Common Side Effects
- Headache (3%)
- Nausea (3%)
- Dizziness (2%)
- Tiredness (2%)
- Dizziness (3%)
- Nausea (2%)
- Vomiting (2%)
- Low blood pressure (2%)
- Swelling of your hands and legs (2%)
- Headache (2%)
Other Side Effects
- Diarrhea
- Belly pain
- Back pain
- Chest pain
- Cough
- Fever
- Muscle spasms
- Trouble catching your breath
- Rash
Serious Side Effects
- Serious allergic reactions: trouble breathing, dizziness, rash, itching, hives, swelling of the tongue or throat
- Dangerously low blood pressure: fainting, nausea, blurry vision, clammy skin, shallow breathing
- Heart problems: flushing, chest discomfort or pain, irregular heartbeat
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Shortness of breath
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Flushing
- Headache
- Joint pain
- Muscle pain
- Nausea
- Pain, redness, or irritation at injection site
Pros and cons of Ferumoxytol (Feraheme)
Pros
Safe to use in people with chronic kidney disease
Two infusions of ferumoxytol (Feraheme) can be given as early as 3 days apart, so it's convenient for people with a busy schedule.
Available as a lower-cost generic medication
Cons
Requires blood pressure monitoring to make sure this medication is safe for you
Potential risk of severe allergic reactions
Given IV, so not a preferred option for people who don't like needles
Pharmacist tips for Ferumoxytol (Feraheme)
It takes at least 15 minutes to give the full dose of ferumoxytol (Feraheme), so plan for this time. Most commonly, you'll receive this medication at an infusion center, hospital, or a provider's office.
Be sure to plan for some extra time after your appointment. Your provider will need to monitor you for allergic reactions and check your blood pressure and pulse during the infusion and for at least 30 minutes after you've received ferumoxytol (Feraheme). Tell your provider right away if you experience wheezing, dizziness, rash, itching, hives, and swelling of the tongue or throat.
Make sure you're lying or sitting down while receiving ferumoxytol (Feraheme). Let your provider know right away if you experience fainting, dizziness, or nausea after you've received ferumoxytol (Feraheme).
If you're on dialysis, you'll need to wait until your blood pressure is stable and at least an hour after your dialysis has started to receive ferumoxytol (Feraheme). Both dialysis and this medication can cause your blood pressure to drop quickly.
Make sure you get blood tests done on time while you're receiving ferumoxytol (Feraheme). By getting regular blood tests done, your provider can continue to make sure this medication is working and is safe for you.
Some medications can worsen the side effects of ferumoxytol (Feraheme). Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before and while you're receiving ferumoxytol (Feraheme). Talk with your provider or pharmacist if you have any questions about interactions with this medication.
Frequently asked questions about Ferumoxytol (Feraheme)
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What are the risks and warnings for Ferumoxytol (Feraheme)?
Ferumoxytol (Feraheme) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious allergic reaction
In some rare cases, ferumoxytol (Feraheme) can cause allergic reactions, which can be life-threatening. Your risk is higher if you've had allergic reactions to medications in the past. Your care team will monitor your blood pressure and heart rate during your infusion and for 30 minutes after your infusion to make sure this medication is safe for you. Watch out for signs and symptoms of allergic reactions, such as wheezing, dizziness, fainting, fast heartbeat, chest pain, rash, itching, hives, and swelling of the tongue or throat. These reactions can happen even if you've safely received ferumoxytol (Feraheme) before. Let your provider know right away if you have any of these allergic reactions.
Lower blood pressure
Risk factors: People on dialysis | Older people with health problems
People who receive ferumoxytol (Feraheme) can sometimes experience lower blood pressure during or after the infusion. This might be your body's allergic response to this medication and it usually goes away with time. Your provider will check your blood pressure each time you receive ferumoxytol (Feraheme) infusion to make sure this medication is safe for you. If you experience fainting, nausea, blurry vision, clammy skin, or shallow breathing during or after your infusion, tell your provider right away.
Too much iron in the blood
Ferumoxytol (Feraheme) can sometimes cause too much iron to be stored up in your blood, which can cause harm to your kidneys and lungs. To prevent this from happening, your provider will monitor how often you get this infusion, and you'll need to get routine blood tests so your provider can check to make sure the amount of iron stored in your body isn't too high.
Inaccurate imaging test
Ferumoxytol (Feraheme) can temporarily get in the way of magnetic resonance imaging (MRI). This medication can deposit iron in the liver, spleen, and bone marrow and cause the MRI images to not be accurate. Consider other forms of imaging, such as ultrasound or X-ray, if it's within 3 months of receiving ferumoxytol (Feraheme). Talk with a provider or radiologist about your medication history before getting any testing done.
Ferumoxytol (Feraheme) dosage forms
Typical dosing for Ferumoxytol (Feraheme)
Ferumoxytol (Feraheme) is usually given in a hospital setting with healthcare providers who can respond to any life-threatening allergic reactions right away. A healthcare provider will make sure you get this medication at the correct dose and time.
In general, the typical dose is 510 mg injected into a vein (IV), followed by a second dose of 510 mg, 3 to 8 days later.
Ferumoxytol (Feraheme) contraindications
Allergy to ferumoxytol (Feraheme) or IV iron products
What are alternatives to Ferumoxytol (Feraheme)?
Treatment of iron deficiency anemia in:
Adults who can't take oral iron supplements
Adults who didn't see improvement in their iron levels after oral iron supplements
Adults with chronic kidney disease (CKD)
Iron-deficiency anemia (anemia due to low iron levels) in adults who either have already tried or can't take iron supplements in pill form
Iron-deficiency anemia in adults with chronic kidney disease (CKD)and aren't on hemodialysis
Iron-deficiency anemia (anemia due to low iron levels) in:
Iron deficiency (low iron levels) in certain adults with heart failure
What is the latest news about Ferumoxytol (Feraheme)?
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References
Best studies we foundAmerican Heart Association. (2023). Low blood pressure - When blood pressure is too low.
Covis Pharma GmbH. (2022). Feraheme delivers clinical efficacy in just 1 gram1,2.
Covis Pharma GmbH. (2022). Feraheme demonstrated non-inferior efficacy in patients with and without chronic kidney disease (CKD)1.
Covis Pharma GmbH. (2022). Understanding iron deficiency anemia (IDA).
Gómez-Ramírez, S., et al. (2019). Prevention and management of acute reactions to intravenous iron in surgical patients. Blood Transfusion.
Lewis, J. L. III. (2023). Hypophosphatemia. Merck Manual Professional Version.
MedlinePlus. (2022). Ferritin blood test.
MedlinePlus. (2023). Iron deficiency anemia.
Sandoz Inc. (2022). Ferumoxytol injection [package insert]. DailyMed.
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA strengthens warnings and changes prescribing instructions to decrease the risk of serious allergic reactions with anemia drug Feraheme (ferumoxytol).
Varallyay, C. G., et al. (2017). What does the boxed warning tell us? Safe practice of using ferumoxytol as an MRI contrast agent. American Journal of Neuroradiology.
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