Is Triferic (ferric pyrophosphate) an option for me if I am on peritoneal dialysis?

No, Triferic (ferric pyrophosphate) hasn't been studied in people receiving [peritoneal dialysis](https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis#whatis) (dialysis that's filtered through your stomach area). It's only for people receiving hemodialysis at a dialysis center.

Triferic

ferric pyrophosphate citrate

Used for Anemia, Kidney Disease

Triferic (ferric pyrophosphate) is one of many injectable iron supplements available. However, it's the first and only FDA-approved medication for the replacement of iron in people with long-term kidney problems who are on hemodialysis.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Kristianne Hannemann, PharmD

Last reviewed on July 19, 2022

What is Triferic (ferric pyrophosphate)?

What is Triferic (ferric pyrophosphate) used for?

Replacement of iron in adults with long-term kidney problems and on hemodialysis (dialysis through the blood)

How Triferic (ferric pyrophosphate) works

Triferic (ferric pyrophosphate) is an iron supplement that helps replenish your body with this important mineral. Iron is an essential component of hemoglobin, a protein in your red blood cells that helps carry and deliver oxygen through your body.

Are you looking for information on Auryxia (ferric citrate), Monoferric (ferric derisomaltose), or Injectafer (ferric carboxymaltose) instead?

Drug facts

Common Brands	Triferic, Triferic AVNU
Drug Class	Iron supplement
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Triferic, Triferic AVNU

Drug Class

Iron supplement

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Triferic (ferric pyrophosphate)

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

Low blood pressure during hemodialysis (22%)
Muscle spasms (10%)
Headache (9%)
Swelling in arms or legs (7%)
Pain in arms or legs (7%)
Shortness of breath (6%)
Back pain (5%)
Fever (5%)
Urinary tract infection (5%)

Less Common Side Effects

Lack of energy
Fatigue

Triferic (ferric pyrophosphate) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Serious allergic reactions: rash, hives, shortness of breath, low blood pressure, fast heartbeat, dizziness, flushing (feeling warm all of a sudden), fatigue

Source: DailyMed

Pros and cons of Triferic (ferric pyrophosphate)

Pros

Conveniently given during hemodialysis sessions
Can be given as either a separate IV infusion (Triferic AVNU) or mixed in with the dialysate solution (Triferic)
Works well to raise iron levels

Cons

Not used in people on peritoneal dialysis
Hasn't been studied in people receiving hemodialysis at home
Brand name only, which can be expensive

Pharmacist tips for Triferic (ferric pyrophosphate)

If you're prescribed Triferic AVNU, you'll receive it as an IV infusion for the length of the dialysis session, which is about 3 to 4 hours.
Mark your appointment(s) on your calendar to help you remember when to visit your dialysis center to receive hemodialysis and Triferic (ferric pyrophosphate). This will make sure you don't miss any doses or sessions.
Make sure you get your blood work done on time if your provider instructs you to. The results from these blood tests help your provider check your iron levels during Triferic (ferric pyrophosphate) treatment.
It's generally recommended to follow an iron-rich diet to help restore your iron levels. Foods containing iron include red meats (like beef or pork), dark leafy greens (like broccoli or kale), beans, and iron-enriched pasta and rice.

Common questions about Triferic

Both brands of the medication (Triferic and Triferic Avnu) are made by the same company and work well to raise your iron levels. The only difference between them is that Triferic AVNU is given as a separate IV injection, whereas Triferic is mixed and given to you with the dialysate solution.

No, Triferic hasn't been studied in people receiving peritoneal dialysis (dialysis that's filtered through your stomach area). It's only for people receiving hemodialysis at a dialysis center.

No, don't take any other iron supplements while receiving Triferic unless your provider specifically told you to do so. This can put you at risk for a condition called hemochromatosis (iron overload) when too much iron builds up in your body. This condition can lead to liver, heart, and joint problems, as well as other organ damage. Let your provider know right away if you experience fatigue, weakness, darkening skin color, or joint pain, because these might be signs of high iron levels in your blood. Keep these signs in mind if your provider recommends that you take another iron supplement after you complete your treatment with Triferic.

Your provider will order certain blood tests that will show how well Triferic is working for you. One of the tests measures your hemoglobin levels. Another test measures your ferritin levels. Ferritin is a protein that stores iron in your body, so the test helps estimate how much iron you have in your body. Your provider might also want to know your transferrin saturation (TSAT) level. Transferrin is a protein that carries iron through your blood to various tissues in your body. When less iron is attached to transferrin proteins, your TSAT results might come back as low, which could mean your iron levels are low. Contact your provider if you have questions on these lab tests and what your results mean.

There haven't been enough studies on how Triferic affects pregnant women, so it's not completely known how safe it is during pregnancy. It's important to note that low iron levels can cause problems during pregnancy. If you're pregnant or thinking of getting pregnant, talk to your provider to see which available treatment options are right for you.

Risks and warnings for Triferic (ferric pyrophosphate)

Triferic (ferric pyrophosphate) 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 reactions

Risk factors: History of allergic reaction to another IV iron product

Triferic (ferric pyrophosphate) can cause serious allergic reactions, including anaphylaxis, which can be life-threatening. Symptoms of an allergic reaction can include rash, hives, shortness of breath, low blood pressure, fast heartbeat, dizziness, flushing, and fatigue. Your provider will monitor you for allergic reactions during and after your dialysis session. If you experience any symptoms of an allergic reaction, seek medical help right away.

Triferic (ferric pyrophosphate) dosage

Typical dosage for Triferic (ferric pyrophosphate)

Triferic AVNU: The typical dose is 6.75 mg given as an injection into the veins (intravenously, IV) during each hemodialysis session.
Triferic: Your provider will determine the correct dose for you. Triferic (ferric pyrophosphate) is mixed with the hemodialysis solution (dialysate) that you receive during your dialysis sessions.