Ferumoxytol

• Ferumoxytol is an intravenous iron preparation used to treat iron deficiency anemia.
• It works by delivering iron directly into the bloodstream, where it is incorporated into hemoglobin and iron stores.
• The medication is primarily indicated for adults with chronic kidney disease or those intolerant to oral iron.
• Common side effects include nausea, dizziness, and headache, while serious hypersensitivity reactions are a rare but significant risk.
• Administration requires careful monitoring due to the potential for adverse reactions.

What is Ferumoxytol: Drug Class and Mechanism of Action

Ferumoxytol is an intravenous iron replacement product belonging to the drug class of iron carbohydrate complexes. It is composed of superparamagnetic iron oxide nanoparticles coated with a carbohydrate shell. This unique structure allows for the stable delivery of iron directly into the bloodstream.

The ferumoxytol drug class and mechanism involve the rapid replenishment of iron stores. Once administered, the iron particles are taken up by reticuloendothelial system macrophages, which then release the iron. This iron subsequently binds to transferrin, a protein responsible for transporting iron throughout the body, and is then delivered to erythroid precursor cells in the bone marrow for incorporation into hemoglobin. This process effectively addresses iron deficiency by providing the necessary building blocks for red blood cell production. This is precisely how ferumoxytol works in the body, by bypassing the gastrointestinal tract and directly supplying iron where it is needed most for erythropoiesis.

What is Ferumoxytol Used For?

Ferumoxytol is used for the treatment of iron deficiency anemia (IDA) in adults. Specifically, it is indicated for adult patients with chronic kidney disease (CKD), regardless of whether they are on dialysis or not. It is also approved for adult patients who have either an intolerance to or an unsatisfactory response to oral iron supplementation. Iron deficiency anemia is a widespread condition; according to the World Health Organization (WHO), it affects a significant portion of the global population, particularly women and children, highlighting the importance of effective treatments like Ferumoxytol for specific patient groups.

By providing a direct and efficient method of iron delivery, Ferumoxytol helps to increase hemoglobin levels and replenish depleted iron stores, thereby alleviating symptoms associated with IDA such as fatigue, weakness, and shortness of breath. Its intravenous route makes it a valuable option for patients who cannot absorb oral iron effectively or who experience significant gastrointestinal side effects from oral iron preparations.

Ferumoxytol Side Effects and Warnings

Like all medications, Ferumoxytol can cause side effects, and it carries important warnings that healthcare providers and patients should be aware of. The most significant concern with Ferumoxytol is the risk of serious hypersensitivity reactions, including anaphylaxis, which can be life-threatening. For this reason, Ferumoxytol should only be administered in an environment where personnel and equipment are available to assess and manage anaphylaxis and other severe reactions. Patients should be monitored for signs and symptoms of hypersensitivity during and for at least 30 minutes after administration.

Common ferumoxytol side effects and warnings include:

• Nausea
• Dizziness
• Headache
• Diarrhea
• Constipation
• Hypotension (low blood pressure)
• Peripheral edema (swelling in limbs)
• Chest pain

Other warnings include the potential for transient but sometimes severe hypotension, especially if the drug is infused too rapidly. It is crucial to monitor vital signs during and after administration. Ferumoxytol can also interfere with magnetic resonance imaging (MRI) studies for up to three months after the last dose, as it is a superparamagnetic iron oxide. Patients should inform their healthcare providers about their Ferumoxytol treatment before undergoing an MRI.