Ferric derisomaltose

Indications

Ferric derisomaltose is prescribed for the treatment of iron deficiency anemia in adult patients who exhibit intolerance to oral iron supplements or have not achieved satisfactory results with orally administered iron. It is also suitable for individuals with chronic kidney disease who are not reliant on hemodialysis. In regions such as Australia and the United Kingdom, the use of ferric derisomaltose is recommended in circumstances where a rapid administration of iron is necessary.

Pharmacodynamics

The principal action of ferric derisomaltose is to elevate reticulocyte counts, which subsequently leads to an increase in hemoglobin levels. This effectively addresses iron deficiency anemia and alleviates its associated symptoms. It should be noted that parenteral iron administration, including ferric derisomaltose, may result in misleadingly elevated serum bilirubin levels and may also mimic reduced levels of serum calcium.

Absorption

Upon administering a single 1000 mg dose of ferric derisomaltose, the maximum concentration (Cmax) and the area under the curve (AUC) for serum iron were recorded at 408 μg/mL and 17730 μg.h/mL, respectively. Peak serum ferritin concentrations are typically observed approximately seven days after the intravenous administration of ferric derisomaltose. It is important to mention that the effectiveness of oral iron absorption diminishes when administered alongside intravenous iron. Consequently, oral iron should not be taken until at least five days have passed since the last injection of ferric derisomaltose.

Metabolism

Once in circulation, ferric derisomaltose is assimilated into plasma by the cells of the reticuloendothelial system (RES). The iron subsequently binds with various proteins to form hemosiderin or ferritin, in addition to associating with transferrin. Through this binding process, the deposited iron plays a crucial role in replenishing both low hemoglobin and iron levels in the body.

Mechanism of Action

Ferric derisomaltose is a pharmaceutical compound comprising iron (III) hydroxide complexed with derisomaltose, an iron carbohydrate oligosaccharide. This formulation is designed to effectively release iron, which subsequently binds to transferrin, a transport protein responsible for delivering iron to erythroid precursor cells. Within these cells, the iron is incorporated into hemoglobin molecules, facilitating the essential process of oxygen transport in the body.