Maltofer

Indications

Maltofer is indicated for the treatment of iron deficiency anemia in adult patients who:

• Experience intolerance or inadequate response to oral iron therapy.
• Have chronic kidney disease without dialysis dependence.

Always use this medication under the supervision of a registered physician.

Description

Maltofer contains colloidal iron (III) hydroxide complexed with carboxymaltose, a carbohydrate polymer designed to release iron effectively.

Dosage & Administration

The dosing of Ferric Carboxymaltose is a stepwise process:

1. Determine Iron Requirements: Iron dosage is calculated based on the patient’s body weight and hemoglobin (Hb) levels:
   • Hb < 10 g/dl:
     • <35 kg: 500 mg
     • 35 kg to <70 kg: 1500 mg
     • 70 kg and above: 2000 mg
   • Hb 10 to 14 g/dl:
     • <35 kg: 500 mg
     • 35 kg to <70 kg: 1000 mg
     • 70 kg and above: 1500 mg
   • Hb > 14 g/dl:
     • 500 mg for all weight categories.
2. Calculate and Administer the Dose: Administer Ferric Carboxymaltose based on the following guidelines:
   • Maximum of 15 mg iron/kg (IV injection) or 20 mg iron/kg (IV infusion).
   • Single dose not to exceed 1,000 mg per week.
3. Post-Treatment Monitoring: Hb levels should be reassessed no sooner than 4 weeks post-administration to allow time for iron absorption and erythropoiesis.

Always use this medication under the supervision of a registered physician.

Interaction

There are no formal studies on drug interactions with Maltofer.

Contraindications

Maltofer (Ferric Carboxymaltose) should not be used in the following cases:

• Hypersensitivity to ferric carboxymaltose or its excipients.
• Known reactions to other intravenous iron products.
• Non-iron deficiency anemia.
• Evidence of iron overload or problems with iron metabolism.

Side Effects

Common Side Effects:

• Nausea, headache, dizziness, and hypertension.
• Injection site reactions, increased alanine aminotransferase, hypophosphatemia.

Uncommon Side Effects:

• Hypersensitivity, taste disturbances, tachycardia, low blood pressure, flushing, shortness of breath, digestive issues, itching, rash, and muscle or joint pain.

Rare Side Effects:

• Anaphylactic reactions, fainting, bronchospasm, angioedema, and flu-like symptoms.

Pregnancy & Lactation

There is limited research on the effects of Ferric Carboxymaltose during pregnancy. Its use should be carefully considered, particularly during the second and third trimesters, if the benefits outweigh the potential risks. It is unlikely to pose a risk to breastfeeding infants based on available data.

Precautions & Warnings

Hypersensitivity Reactions: Life-threatening reactions, including anaphylaxis, have been reported. Monitor patients for 30 minutes post-administration, ensuring immediate access to emergency treatment.

Hypertension: Temporary increases in systolic blood pressure, sometimes accompanied by flushing, dizziness, or nausea, may occur. Monitor patients for these symptoms during and after treatment.

Use in Special Populations

• Chronic Kidney Disease: In patients undergoing dialysis, the maximum daily dose should not exceed 200 mg of iron.
• Pediatric Use: Maltofer is not recommended for children under 14 years due to insufficient data.

Overdose Effects

Excess iron may lead to accumulation and conditions like hemosiderosis. Regular monitoring of iron parameters, such as serum ferritin and transferrin saturation, is advised. Iron chelators may be used in cases of iron overload.

Therapeutic Class

Parenteral Iron Preparations

Storage Guidelines

Store Maltofer in a cool, dry place (below 30°C), away from direct light. Avoid freezing and keep out of reach of children.