ferric pyrophosphate

Action and Spectrum

Actions and Spectrum: 

ferric pyrophosphate is a type of intravenous iron supplement used to treat iron deficiency anemia. It is designed to be used during hemodialysis or peritoneal dialysis treatments in patients with end-stage renal disease. Ferric pyrophosphate acts by binding to transferrin, the protein that transports iron in the blood, and then delivering iron to the bone marrow where it is used to produce hemoglobin. ferric pyrophosphate has a broad spectrum of activity and can effectively treat iron deficiency anaemia in patients with chronic kidney disease who are undergoing dialysis.

It has been shown to increase haemoglobin levels and reduce the need for erythropoiesis-stimulating agents, which are commonly used to treat anaemia in these patients. Ferric pyrophosphate also has a favourable safety profile and is generally well-tolerated by patients. However, it is important to monitor patients for adverse reactions, such as hypersensitivity reactions and hypotension, which can occur with any intravenous iron supplement. 

Drug Interaction

Adverse Reaction

Frequency Defined  

1-10%  

Headache (9%)  

Pain in extremity (7%)  

Peripheral edema (7%)  

Dyspnea (6%)  

Muscle spasms (10%)  

Urinary tract infection (5%)  

Pyrexia (5%)  

Back pain (5%)  

Fatigue (4%)  

Asthenia (4%)  

>10%  

Procedural hypotension (22%)

Black Box Warning

Black Box Warning: 

There is no black box warning for ferric pyrophosphate IV 

Contraindication / Caution

Contraindication/Caution: 

ferric pyrophosphate IV is an iron supplement administered intravenously to treat iron deficiency anemia in patients with chronic kidney disease on hemodialysis. Some of the contraindications and cautions of ferric pyrophosphate IV include:  

• Hypersensitivity: ferric pyrophosphate IV is contraindicated in patients with a known hypersensitivity to the drug or any of its components. It can cause allergic reactions, which can be severe and life-threatening.  
• Iron overload: ferric pyrophosphate IV should be used with caution in patients with a history of iron overload or other conditions that increase the risk of iron accumulation in the body. Iron overload can cause organ damage, including liver damage.  
• Infection: it should be used with caution in patients with active infections, as it can worsen the infection or cause sepsis.  
• Cardiovascular disease: it should be used with caution in patients with a history of cardiovascular disease, as it can exacerbate hypertension or cause hypotension.  
• Pregnancy and breastfeeding: it should be used with caution in pregnant or breastfeeding women, as the safety of the drug in these populations has not been established.  
• Children: The safety and efficacy of ferric pyrophosphate IV have not been established in children. It should only be used in children under the guidance of a pediatrician.

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:  

ferric pyrophosphate is an intravenous iron supplement used to treat iron deficiency anemia.  

Pharmacodynamics: 

It works by providing iron to the body, which is necessary to produce hemoglobin and other enzymes. After administration, ferric pyrophosphate is rapidly distributed to the plasma and other tissues. The iron in ferric pyrophosphate is released slowly and is bound to transferrin, a protein that transports iron in the body. The iron is then taken up by cells and used to produce hemoglobin and other enzymes.  

ferric pyrophosphate has a lower risk of causing anaphylactic reactions compared to other intravenous iron supplements, such as iron dextran and iron sucrose. It is also less likely to cause hypotension and other adverse effects. Ferric pyrophosphate can be administered at a higher dose and more quickly than other intravenous iron supplements, which reduces the time required for administration.  

Pharmacokinetics: 

Absorption  

As ferric pyrophosphate is administered intravenously, it bypasses the absorption step in the ADME process. Therefore, it is fully available for distribution after administration.  

Distribution  

After administration, ferric pyrophosphate is distributed throughout the body via the bloodstream. It is primarily distributed to the bone marrow, where it is used for the synthesis of hemoglobin.  

Metabolism  

ferric pyrophosphate does not undergo significant metabolism in the body. It is broken down into ferric ions, which are used by the body for various metabolic processes.  

Elimination and Excretion  

ferric pyrophosphate is excreted from the body via the reticuloendothelial system (RES) after being taken up by cells in the liver and spleen. Small amounts of iron are lost from the body through excretion in feces, urine, and sweat.

Adminstartion

Administration:  

ferric pyrophosphate is a type of intravenous iron supplement used to treat iron deficiency anemia. It is administered through a needle inserted into a vein, usually in the arm or hand. Here are the steps for the administration of ferric pyrophosphate IV:  

• Before administering ferric pyrophosphate, the healthcare provider will check the patient’s blood pressure, heart rate, and other vital signs. They will also ask the patient about any allergies or medical conditions that could affect the administration of the drug.  
• The healthcare provider will then prepare the ferric pyrophosphate by diluting it with sterile water or normal saline solution, depending on the dose prescribed by the doctor.  
• The healthcare provider will then insert a sterile needle into the patient’s vein and connect it to a bag containing the diluted ferric pyrophosphate.  
• The ferric pyrophosphate will be infused slowly into the vein over a period of several hours, usually 2-3 hours. The infusion rate may be adjusted based on the patient’s response and the severity of their anemia.  
• During the infusion, the healthcare provider will monitor the patient’s vital signs, including blood pressure and heart rate. They will also check for any signs of an allergic reaction or other adverse effects.  
• After the infusion is complete, the healthcare provider will remove the needle from the patient’s arm and apply pressure to the injection site to prevent bleeding.  
• The patient will be monitored for a short period of time after the infusion to ensure that they do not experience any adverse effects from the medication.

Patient Information Leaflet

Patient information leaflet 

Generic Name: ferric pyrophosphate IV 

Why do we use ferric pyrophosphate IV? 

ferric pyrophosphate IV is used to treat iron deficiency anemia in patients who are unable to take iron supplements orally or when oral iron is not effective. Iron deficiency anemia occurs when the body does not have enough iron to produce hemoglobin, the protein in red blood cells that carries oxygen throughout the body. ferric pyrophosphate is a type of iron supplement that is administered intravenously to provide iron to the body.  

ferric pyrophosphate is preferred over other intravenous iron supplements because it has a lower risk of causing anaphylactic reactions and can be administered more quickly. It is commonly used in patients with chronic kidney disease who are on hemodialysis and have anemia. ferric pyrophosphate helps to increase the hemoglobin levels in these patients, which can improve their quality of life and reduce the need for blood transfusions