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
Side effects of Ferumoxytol (Feraheme)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Side effects experienced by people without CKD:
- Headache (3%)
- Nausea (3%)
- Dizziness (2%)
- Tiredness (2%)
Side effects experienced by people with CKD:
- Dizziness (3%)
- Nausea (2%)
- Vomiting (2%)
- Low blood pressure (2%)
- Swelling of your hands and legs (2%)
- Headache (2%)
Less Common Side Effects
- Diarrhea
- Belly pain
- Back pain
- Chest pain
- Cough
- Fever
- Muscle spasms
- Trouble catching your breath
- Rash
Ferumoxytol (Feraheme) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
The following Ferumoxytol (Feraheme) 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
- Painful swelling, warmth, or redness of the skin, brown or dark skin color at the infusion site
- Shortness of breath
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Flushing
- Headache
- Joint pain
- Muscle pain
- Nausea
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.
Common questions about Ferumoxytol (Feraheme)
In general, iron infusions (like ferumoxytol (Feraheme)) work faster at raising your iron levels compared to oral iron supplements. In clinical studies that lasted for about a month, people who've received ferumoxytol (Feraheme) treatment saw their hemoglobin (protein in red blood cells that carries oxygen), ferritin (protein in cells that stores iron), and blood iron levels improve more than that of people who took oral iron supplements. If you have any questions about this medication, follow up with your provider for more information.
It's hard to say how long each treatment of ferumoxytol (Feraheme) might last because this can differ from person to person. Your provider will likely ask you to do lab tests regularly after you've received ferumoxytol (Feraheme) to check your iron levels and red blood cell levels. Sometimes, you might need to receive multiple treatments of ferumoxytol (Feraheme). Talk with your provider if you've more questions about how long ferumoxytol (Feraheme) might last.
Ferumoxytol (Feraheme) can lower the levels of phosphorus in your body, but not as much compared with Injectafer (ferric carboxymaltose), another injectable iron supplement. Tell your provider right away if you have symptoms of low phosphorus including muscle weakness or low appetite.
Ferumoxytol (Feraheme) and Venofer (iron sucrose) are both injectable medications that raise the levels of iron in people with IDA. In a clinical study, both medications worked similarly well in treating people with IDA. One main difference between the two medications is that Ferumoxytol (Feraheme) is only for adults who can't take oral iron medications or have CKD, while Venofer (iron sucrose) is for people ages 2 years and older with CKD. Another difference is that less people experience side effects with ferumoxytol (Feraheme) compared to Venofer (iron sucrose). Talk with your provider to determine which medication is best for you.
Ferumoxytol (Feraheme) hasn’t been well studied in pregnant people, but animal studies suggest this medication can cause harm in pregnancy. While it's important to treat IDA during pregnancy to prevent early delivery or low birth weight, your provider will talk with you about safer options.
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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
Typical dosage 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
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ferumoxytol (Feraheme) will not be safe for you to take.
- Allergy to ferumoxytol (Feraheme) or IV iron products
What are alternatives to Ferumoxytol (Feraheme)?
