Ferumoxytol (Intravenous)

Overview

The term 'chronic kidney disease' encompasses a variety of conditions that affect the functioning of the kidneys. If untreated, kidney function can deteriorate over time and, as a result, waste builds up in the body. When patients are suffering from chronic kidney or renal disease, they can display a number of symptoms, such as high blood pressure, weak bones and nerve damage.

Another complication of chronic kidney disease is anemia. When the kidneys are working normally, they produce erythropoietin. This hormone causes the bone marrow to produce red blood cells and these carry oxygen around the patient's body. When the kidneys aren't working effectively, however, levels of erythropoietin are reduced and fewer red blood cells are produced.

When there aren't enough red blood cells to carry an adequate amount of oxygen around the body, anemia can occur. Although there are various types of anemia, patients suffering from the condition as a complication of kidney disease are normally diagnosed with iron deficiency anemia.

Supplementing the patient with iron can, therefore, help to reverse the symptoms associated with anemia. When patients require iron supplementation, they may be given iron in tablet form. Although this can be effective for many people, supplementing it intravenously can be more effective and can increase the patient's iron levels more quickly.

Ferumoxytol injections, for example, are able to restore the patient's iron levels to a normal level within a relatively short timeframe. As patients with chronic kidney disease are likely to require on-going iron supplementation, delivering Ferumoxytol intravenously is often the most appropriate form of treatment.

Without effective supplementation, patients can experience a wide range of unpleasant symptoms. Iron deficiency anemia can often cause patients to feel extremely fatigued, for example, and they may also experience shortness of breath and a feeling of weakness. In addition to this, iron deficiency anemia can cause feelings of faintness, confusion and increased thirst.

Fortunately, iron deficiency anemia can be treated effectively with medications, such as Ferumoxytol. Once patients are diagnosed with chronic kidney disease, their iron levels should be monitored on a regular basis. By carrying out regular blood tests, physicians can identify when patients require intravenous Ferumoxytol infusions and how much medication is required.

Conditions Treated

  • Iron deficiency anemia caused by chronic kidney disease

Type Of Medicine

  • Iron replacement

Side Effects

When Ferumoxytol is administered, patients may notice some side effects occurring. Unless they are particularly severe or uncomfortable, the following side effects may not need medical intervention:

  • Stomach or abdominal pain
  • Headache
  • Back pain
  • Muscle spasms

However, there are some side effects that do require medical treatment. If patients notice any of the following adverse effects during or following treatment with Ferumoxytol, they should notify their doctor or nurse immediately:

  • Swelling or bloating of the arms, face, hands, feet or lower legs
  • Chest pain
  • Blurred vision
  • Labored or difficult breathing
  • Confusion
  • Lightheadedness, faintness or dizziness when getting up suddenly from a sitting or lying position
  • Fainting
  • Irregular, pounding or fast pulse or heartbeat
  • Fever
  • Extreme fatigue
  • Rapid weight gain
  • Dizziness
  • Sweating
  • Dilated veins in the neck
  • Tightness in the chest
  • Difficulty swallowing
  • Tingling of the feet or hands
  • Decreased urine output
  • Unusual weakness or tiredness
  • Cough
  • Unusual weight loss or gain
  • Chest discomfort
  • Bluish color of the lips, palms, skin, fingernails or nail beds
  • Itching, hives or rash on the skin
  • Loss of consciousness
  • Irregular breathing
  • Nausea or vomiting
  • Large, hive-like swelling on the eyelids, face, lips, throat, tongue, legs, hands, feet and sex organs
  • Pain in the jaw, neck arms or shoulders
  • No blood pressure or pulse
  • Swelling or puffiness around the eyes or of the eyes, eyelids, lips face or tongue
  • Unconsciousness
  • Stopping of the heart
  • Unresponsiveness

Similarly, patients should seek medical help if they experience any other side effects whilst they are being treated with Ferumoxytol.

Dosage

When patients are given Ferumoxytol to treat iron deficiency anemia, they are usually prescribed a dose of 510 mg. This is delivered intravenously, which means that a doctor or nurse will administer the medication via the patient's vein. Following the initial dose, another dose of 510mg is usually administered three to eight days later.

Although it doesn't take long for Ferumoxytol to be administered intravenously, the medicine should not normally be delivered at a speed higher than 30mg per second.

As patients with chronic kidney disease are unable to produce enough erythropoietin to make an adequate amount of red blood cells, they are likely to suffer from recurring iron deficiency anemia. Due to this, they will need repeated treatments with Ferumoxytol in order to ensure that they do not develop anemia.

Although this is a standard treatment regime, every patient will be assessed individually. It is possible, therefore, that patients could be given a different dose of Ferumoxytol, if their doctor modifies their treatment in some way.

Potential Drug Interactions:

Patients should be aware that medications can sometimes interact with one another and this can cause unwanted effects to occur. Due to this, patients should inform their doctor if they are taking any prescription medicines, over the counter medicines, supplements or vitamins, before they are treated with Ferumoxytol.

In addition to this, patients should obtain medical advice before taking any other medicines, supplements or vitamins once they have been treated with Ferumoxytol.

Warnings

Before treatment commences, patients should disclose any existing medical conditions to their doctor. There are some conditions that may affect the suitability of Ferumoxytol injections as a treatment, and these include:

  • Low blood pressure (hypotension)
  • Iron overload
  • Liver disease
  • Heart disease

Although younger patients may be treated with Ferumoxytol injections, specific studies have not been carried out on the effects of Ferumoxytol on pediatric patients. Due to this, physicians may be unwilling to prescribe Ferumoxytol to pediatric patients or may only prescribe Ferumoxytol injections to younger patients if the benefits of treatment clearly outweigh any possible risks.

Ferumoxytol injections can be prescribed to older patients and there shouldn't be any specific risks in administering treatment to geriatric patients. However, older patients may be more likely to have age-related liver or heart problems and this could prevent them from metabolizing medicine as quickly as normally. Due to this, a lower dose of Ferumoxytol may be required.

If Ferumoxytol is prescribed to pregnant women, there is a chance that the medicine could cause harm to the unborn fetus. Due to this, Ferumoxytol injections should only be prescribed to pregnant patients in cases where the risks are outweighed by the benefits. If patients become pregnant during a course of Ferumoxytol treatment, they should inform their physician immediately.

It is not yet known if Ferumoxytol is transferred to infants via breastfeeding. However, potential harm could occur if the medicine is passed to an infant via breastfeeding. Due to this, patients are normally advised not to breastfeed if they are being treated with Ferumoxytol injections.

When receiving Ferumoxytol injections, patients may experience dizziness, fainting or lightheadedness. These symptoms may be worse when the patient gets up from a lying down or sitting position. Often, these symptoms improve as the patient becomes accustomed to the medication.

Ferumoxytol may alter the results of medical tests, so patients should inform any relevant healthcare practitioners that they are being treated with Ferumoxytol before undergoing any tests or procedures.

When patients are being treated with Ferumoxytol, they will need to undergo regular blood testing. This will ensure that their red blood cell count is within a normal range and that the medicine isn't causing any unwanted effects.

In rare cases, patients may display a serious allergic reaction whilst being treated with Ferumoxytol. If so, they will require emergency medical assistance. Anaphylaxis is a life-threatening condition and often includes the following symptoms:

  • Wheezing
  • Shortness of breath
  • Lightheadedness
  • Itching
  • Rash on the skin
  • Hoarseness
  • Fainting
  • Dizziness
  • Difficulty swallowing
  • Difficulty breathing
  • Swelling of the face, mouth, lips, tongue, throat or hands

Storage

Normally stored in single-use vials, Ferumoxytol should be kept at a controlled room temperature of 20?-25?C (68?-77?F). However, Ferumoxytol is administered intravenously and the patient will, therefore, be given the medicine in a clinical setting.

Due to this, patients will not need to store, prepare or administer Ferumoxytol injections themselves.

Summary

When patients are diagnosed with chronic kidney disease, they may need various types of treatments in order to reduce the complications associated with the condition. If kidney disease can be halted or treated, it may prevent the patient from developing kidney failure. In addition to this, treating the symptoms of kidney disease can help to prevent further health complications from occurring.

As kidney disease affects the body's production of red blood cells, patients typically develop iron deficiency anemia. Without iron supplementation, anemia can cause numerous symptoms and can be fairly debilitating in itself. When treated with Ferumoxytol injections, however, the patient's iron levels can be restored to a normal level. As a result, patients with chronic kidney disease can be prevented from developing iron deficiency anemia, or can be successfully treated if anemia is already established.