Table 2. Intravenous iron formulations... | American Society of Hematology

Table 2.

Intravenous iron formulations with FDA-approved indications in children

Formulation	Approved pediatric indication	Approved dosing and administration notes^*
Iron dextran^†	Children over 4 months of age	Dose (mL) = 0.0442 (Desired Hgb – Observed Hgb) × LBW + (0.26 × LBW) Requires test dose prior to full therapeutic dose
Iron sucrose	Iron maintenance in patients ≥2 years with dialysis-dependent or non-dialysis-dependent CKD receiving erythropoietin therapy	Dose = 0.5 mg/kg, not to exceed 100 mg per dose every 2 weeks (for hemodialysis-dependent patients) or 4 weeks (for non-dialysis-dependent patients on erythropoietin therapy) for 12 weeks
Ferric gluconate	Treatment of IDA in pediatric patients ≥6 years undergoing chronic hemodialysis receiving erythropoietin therapy	Dose = 0.12 mL/kg (1.5 mg/kg of elemental iron) administered intravenously over 1 hour during 8 sequential dialysis sessions (maximum 125 mg per dose)
Ferric carboxymaltose	Treatment of children aged >1 year with IDA who are intolerant of oral iron or who have unsatisfactory response to oral iron	Patients <50 kg: 15 mg/kg/dose for 2 doses Patients ≥50 kg: 750 mg/dose for 2 doses Separate doses by at least 7 days Alternative dose is 15 mg/kg (maximum 1000 mg) as single infusion Associated with hypophosphatemia

Formulation	Approved pediatric indication	Approved dosing and administration notes^*
Iron dextran^†	Children over 4 months of age	Dose (mL) = 0.0442 (Desired Hgb – Observed Hgb) × LBW + (0.26 × LBW) Requires test dose prior to full therapeutic dose
Iron sucrose	Iron maintenance in patients ≥2 years with dialysis-dependent or non-dialysis-dependent CKD receiving erythropoietin therapy	Dose = 0.5 mg/kg, not to exceed 100 mg per dose every 2 weeks (for hemodialysis-dependent patients) or 4 weeks (for non-dialysis-dependent patients on erythropoietin therapy) for 12 weeks
Ferric gluconate	Treatment of IDA in pediatric patients ≥6 years undergoing chronic hemodialysis receiving erythropoietin therapy	Dose = 0.12 mL/kg (1.5 mg/kg of elemental iron) administered intravenously over 1 hour during 8 sequential dialysis sessions (maximum 125 mg per dose)
Ferric carboxymaltose	Treatment of children aged >1 year with IDA who are intolerant of oral iron or who have unsatisfactory response to oral iron	Patients <50 kg: 15 mg/kg/dose for 2 doses Patients ≥50 kg: 750 mg/dose for 2 doses Separate doses by at least 7 days Alternative dose is 15 mg/kg (maximum 1000 mg) as single infusion Associated with hypophosphatemia

See product package insert for additional administration and dosing guidelines.

Large intravenous doses associated with delayed reactions: arthralgias, fever, nausea, and chills 24 to 48 hours after administration.

Hgb, hemoglobin; LBW, lean body weight.