AlternativeFerinject

Ferric Carboxymaltose

IV iron replacement

Single-dose IV iron for pregnancy anaemia intolerant to oral iron.

IV infusion

First-line for

Pregnancy IDA (T2/T3) with oral intolerance/failure
Postpartum anaemia with Hb <90

Mechanism

Carbohydrate-encapsulated ferric hydroxide releases iron slowly to transferrin and reticuloendothelial stores.

"Ferinject = fast, single, second-trimester onwards"

Avoid in T1
Watch for hypophosphataemia after repeat doses
Anaphylaxis risk — 30-min post-infusion observation

Dosing

Dose: Weight × (target Hb - actual Hb) × 2.4 + iron stores (max 1000 mg per session)
Infusion: ≤1000 mg over 15 min in 250 mL NaCl 0.9%

Contraindications

AbsoluteT1 pregnancy
AbsoluteHypersensitivity to iron preparations
AbsoluteActive infection (feeds bacteria)

Side effects

Hypersensitivity/anaphylaxis (rare)
Hypophosphataemia (repeat dosing)
Injection-site skin staining
Transient hypertension, flushing

Fetal & maternal notes

• Safe T2/T3
• Do NOT use in first trimester (theoretical fetal risk)

Key interactions

Oral iron
Caution
Stop 5 days prior — avoid duplication

Clinical pearls

💡 Full resuscitation equipment must be on standby
💡 Check phosphate at 2 weeks if repeat dose needed

Content last reviewed: REPLACE_ME (e.g. 2026-07)

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