We asked , and you answered ! Here are a few responses from this month ’ s “ You Make the Call .” |
For a young pregnant woman in second trimester or beyond , ferric carboxymaltose would be appropriate . It can be administered weekly up to 1,000 mg / dose , depending on degree of deficiency and any anemia .
Andrew Shearer , MBBS Cairns , Australia
|
Two doses of ferric carboxymaltose injection 750 mg .
Iron carboxymaltose 1 mg IV .
Maurice Schwarz , MD Mechanicsville , VA
Riton Das , MD Port Macquarie , Australia
|
We have in our country iron polymaltose 500 mg for IV use . Not knowing the hemoglobin and ferritin levels , I would prescribe two 500 mg doses in 15 days .
Jorge David Korin , MD Buenos Aires , Argentina
I would treat with iron carboxymaltose 1 g . It is safe in second and third trimesters . One could also give iron polymaltose 1 g .
|
||
For the full description of the clinical dilemma , and to see how the expert responded , turn to page 47 . |
|||||
|
Clinical Dilemma :
A pregnant woman who has had bariatric surgery is very iron deficient . We are having difficulty obtaining iron sucrose . We plan to treat her during the second trimester . Are the other forms of intravenous ( IV ) iron safe ? If so , which ones and at what dose ?
|
|||||
We use iron dextran 1,000 mg IV over 3- to 4-hour infusions routinely in pregnant women . We only give acetaminophen 650 mg for pre-medication . We do not like making patients return for multiple infusions of small doses of IV iron , which is what occurs with iron sucrose or citrate . The copay for ferric carboxymaltose has been prohibitive for many of our patients , so we use it rarely . |
|||||
Sally Stabler , MD Aurora , CO |
|||||
|
The patient would certainly benefit from other new parenteral iron formulations .
At our hospital , we routinely treat iron deficient pregnant patients with one to two doses of ferric carboxymaltose 500 mg . Since the introduction of this formulation to the hospital pharmacy , we have treated over 50 patients with good results and minimal side effects .
Up to 1,000 mg of elemental iron can be injected at each session and the iron profile can be re-evaluated at least seven days after injection . We use the usual formula for iron repletion for both non-pregnant and pregnant women .
|
|||||
|
Ebrahim Osfouri , MD Bushehr University of Medical Sciences
Bushehr , Iran
|
|||||
6 ASH Clinical News |