Ferric Pyrophosphate IV

Ferric Pyrophosphate IV is a prescription medication used for the replacement of iron to maintain hemoglobin in patients with hemodialysis-dependent chronic kidney disease (HDD-CKD).

• Ferric Pyrophosphate IV is available under the following different brand names: Triferic AVNU

Common side effects of Ferric Pyrophosphate IV include:

• headache
• swelling of extremities
• weakness/lethargy
• AV fistula thrombosis
• urinary tract infection (UTI)
• AV fistula site hemorrhage
• fever
• fatigue
• procedural low blood pressure (hypotension)
• muscle spasms
• pain in extremities
• back pain, and
• shortness of breath

Serious side effects of Ferric Pyrophosphate IV include:

• rash
• hives 
• shortness of breath
• low blood pressure 
• fast heartbeat
• dizziness
• flushing, and fatigue
• bleeding around your dialysis vein access point
• blue-colored skin, bulging purple-colored veins that are visible through the skin
• swelling in the arms, legs, or fingers
• unusual bleeding or bruising, coughing up blood
• a light-headed feeling
• fever
• pain or burning while passing urine

Rare side effects of Ferric Pyrophosphate IV include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors.
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Dose expressed as mg of iron (III)

Injectable solution

• 1.5 mg/mL (4.5-mL single-dose ampule)

Iron replacement

Adult dosage

• 6.75 mg iron (III) IV at each hemodialysis (HD) session
• Dosage is expressed as mg of iron (III)
• Administer at each dialysis procedure for as long as patients are receiving maintenance HD therapy for CKD

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Ferric Pyrophosphate IV has no noted severe interactions with any other drugs
• Ferric Pyrophosphate IV has no noted serious interactions with any other drugs
• Ferric Pyrophosphate IV has no noted moderate interactions with any other drugs
• Ferric Pyrophosphate IV has no noted minor interactions with any other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• None

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Ferric Pyrophosphate IV?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Ferric Pyrophosphate IV?”

Cautions

• Determine iron status on predialysis blood samples; post-dialysis serum iron parameters may overestimate serum iron and transferrin saturation
• Hypersensitivity reactions
  • Serious hypersensitivity reactions, including anaphylactic-type reactions, some life-threatening and fatal, have been reported in patients receiving parenteral iron products
  • Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse
  • Monitor for signs and symptoms of hypersensitivity during and after HD until clinically stable
  • Personnel and therapies should be immediately available to treat, if necessary

Pregnancy and Lactation

• No data available on use in pregnant women to inform a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
• Lactation
  • There are no data on the presence of ferric pyrophosphate citrate in human milk, its effects on the breastfed child, or milk production