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For your specific specialty, access information below about the patients you're seeing and how to test for, diagnose, and manage iron deficiency anemia (IDA).

Internal Medicine

A wide variety of patient types should be tested for IDA

A wide variety of patient types should be tested for IDA

IDA and Cancer Icon IDA and cancer

There is a 44% to 50% prevalence of IDA across tumor types, including hematological malignancies.49

IDA in Women Icon IDA in women*

In the United States, 1 in 5 women of childbearing age have IDA.40

IDA Gastrointestinal Disease Icon IDA and gastrointestinal (GI) diseases and conditions

There is a 36% to 76% prevalence of IDA in patients with inflammatory bowel disease (IBD).11

IDA and Heart Failure Icon IDA and heart failure

17% of patients with chronic heart failure (CHF) have iron deficiency and anemia.38

IDA and Kidney Disease Icon IDA and non-dialysis-dependent chronic kidney disease (NDD-CKD)

There is a 58% to 73% prevalence of low iron tests in patients with NDD-CKD.50† Injectafer may be used as first-line therapy in adult patients with NDD-CKD.4

IDA and Kidney Disease Icon
IDA and non-dialysis-dependent chronic kidney disease (NDD-CKD)

There is a 58% to 73% prevalence of low iron tests in patients with NDD-CKD.50† Injectafer may be used as first-line therapy in adult patients with NDD-CKD.4

*Injectafer has not been studied in pregnant women. Injectafer should be prescribed during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Defined in reference as a serum ferritin <100 ng/mL or TSAT <20%. Authors concluded this remarkably high prevalence might indicate these indices may not be specific enough and may falsely identify too many patients as iron deficient.

Signs and symptoms33

Symptoms of IDA are related to decreased oxygen delivery to the entire body. Your patients with IDA may experience these symptoms:

  • Pallor
  • Unexplained fatigue
  • Dyspnea or chest pain, especially with activity
  • Unexplained generalized asthenia
  • Rapid heartbeat
  • Pounding or "whooshing" in the ears
  • Headache, especially with activity
  • Pica – an unusual craving for nonfood items
  • Glossitis
  • Koilonychia
  • Hair loss

Diagnosing and managing IDA25,33

IDA is diagnosed through many laboratory tests. Blood tests should include a complete blood count (CBC) and other tests that evaluate iron levels. Different specialties may include additional tests. For example, a gastroenterologist may need to check for blood in the stool to see whether there is internal bleeding.

The more common tests include:

  • Hemoglobin and hematocrit
  • Serum ferritin
  • Transferrin or total iron-binding capacity
See the common laboratory markers used to monitor IDA.

Injectafer restores iron

For the treatment of iron deficiency anemia, intravenous (IV) iron should be considered when oral iron is ineffective.

Injectafer is a 100% dextran-free IV iron indicated for adult IDA patients of various etiologies. Injectafer is the only FDA-approved IV iron that provides 1500 mg of iron in 2 administrations, up to 750 mg each, separated by at least 7 days.2,4‡

Injectafer has not been studied in pregnant women. Injectafer should be prescribed during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Take two 750 mg doses of Injectafer 7 days apart for a total course up to 1500 mg. IV infussion over at least 15 minutes or slow IV push over 7.5 minutes Take two 750 mg doses of Injectafer 7 days apart for a total course up to 1500 mg. IV infussion over at least 15 minutes or slow IV push over 7.5 minutes
Injectafer treatment may be repeated if iron deficiency anemia reoccurs. Monitor serum phosphate levels in patients at risk for low serum phosphate who require a repeat course of treatment (see Important Safety Information).

In Injectafer clinical trials, serious anaphylactic/anaphylactoid reactions were reported in 0.1% (2/1775) of subjects receiving Injectafer.4

§For adult patients weighing less than 50 kg (110 lb), give each dose as 15 mg/kg body weight for a total cumulative dose not to exceed 1500 mg of iron per course of treatment.

||When administered via IV infusion, dilute up to 750 mg of iron in no more than 250 mL of sterile 0.9% sodium chloride injection, USP, such that the concentration of the infusion is not <2 mg of iron per mL and administer over at least 15 minutes. When administered as a slow IV push, give at the rate of approximately 100 mg (2 mL) per minute.

Injectafer is not indicated to treat the symptoms of IDA.

CHOOSING INJECTAFER: VIDEO LIBRARY

Choosing Injectafer: VIDEO LIBRARY

Important Safety Information

INDICATIONS

Injectafer® (ferric carboxymaltose injection) is indicated for the treatment of iron deficiency anemia (IDA) in adult patients who have intolerance to oral iron or have had unsatisfactory response to oral iron, or who have non-dialysis dependent chronic kidney disease.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

Injectafer is contraindicated in patients with hypersensitivity to Injectafer or any of its inactive components.

WARNINGS AND PRECAUTIONS

Symptomatic hypophosphatemia requiring clinical intervention has been reported in patients at risk of low serum phosphate in the postmarketing setting. These cases have occurred mostly after repeated exposure to Injectafer in patients with no reported history of renal impairment. Possible risk factors for hypophosphatemia include a history of gastrointestinal disorders associated with malabsorption of fat-soluble vitamins or phosphate, concurrent or prior use of medications that affect proximal renal tubular function, hyperparathyroidism, vitamin D deficiency and malnutrition. In most cases, hypophosphatemia resolved within three months.

Monitor serum phosphate levels in patients at risk for low serum phosphate who require a repeat course of treatment.

Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Injectafer. Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse. Monitor patients for signs and symptoms of hypersensitivity during and after Injectafer administration for at least 30 minutes and until clinically stable following completion of the infusion. Only administer Injectafer when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. In clinical trials, serious anaphylactic/anaphylactoid reactions were reported in 0.1% (2/1775) of subjects receiving Injectafer. Other serious or severe adverse reactions potentially associated with hypersensitivity which included, but were not limited to, pruritus, rash, urticaria, wheezing, or hypotension were reported in 1.5% (26/1775) of these subjects.

In clinical studies, hypertension was reported in 3.8% (67/1775) of subjects. Transient elevations in systolic blood pressure, sometimes occurring with facial flushing, dizziness, or nausea were observed in 6% (106/1775) of subjects. These elevations generally occurred immediately after dosing and resolved within 30 minutes. Monitor patients for signs and symptoms of hypertension following each Injectafer administration.

In the 24 hours following administration of Injectafer, laboratory assays may overestimate serum iron and transferrin bound iron by also measuring the iron in Injectafer.

ADVERSE REACTIONS

In two randomized clinical studies, a total of 1775 patients were exposed to Injectafer, 15 mg/kg of body weight, up to a single maximum dose of 750 mg of iron on two occasions, separated by at least 7 days, up to a cumulative dose of 1500 mg of iron. Adverse reactions reported by ≥2% of Injectafer-treated patients were nausea (7.2%); hypertension (3.8%); flushing/hot flush (3.6%); blood phosphorus decrease (2.1%); and dizziness (2.0%).

The following adverse reactions have been identified during post approval use of Injectafer. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

The following adverse reactions have been reported from the post-marketing spontaneous reports with Injectafer: cardiac disorders: tachycardia; general disorders and administration site conditions: chest discomfort, chills, pyrexia; metabolism and nutrition disorders: hypophosphatemia; musculoskeletal and connective tissue disorders: arthralgia, back pain, hypophosphatemic osteomalacia (rarely reported event); nervous system disorders: syncope; respiratory, thoracic and mediastinal disorders: dyspnea; skin and subcutaneous tissue disorders: angioedema, erythema, pruritus, urticaria.

CLINICAL CONSIDERATIONS IN PREGNANCY

Untreated IDA in pregnancy is associated with adverse maternal outcomes such as postpartum anemia. Adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight.

Severe adverse reactions including circulatory failure (severe hypotension, shock including in the context of anaphylactic reaction) may occur in pregnant women with parenteral iron products (such as Injectafer) which may cause fetal bradycardia, especially during the second and third trimester.

You are encouraged to report Adverse Drug Events to American Regent, Inc. at 1-800-734-9236 or to the FDA by visiting www.fda.gov/medwatch or calling 1-800-FDA-1088.

Please see Full Prescribing Information.

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