ferric pyrophosphate citrate

General

Pronunciation:
fer-ik pye-roe-fos-fate sit-rate

Trade Name(s)

  • Triferic

Ther. Class.
antianemics

Pharm. Class.
iron supplements

Indications

Replacement of iron to maintain hemoglobin in patients with hemodialysis-dependent chronic kidney disease.

Action

Iron delivered into the circulation binds to transferrin for transport to erythroid precursor cells to be incorporated into hemoglobin.

Therapeutic Effect(s):

Maintenance of hemoglobin levels.

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Minimal distribution to tissues.

Metabolism and Excretion: Unknown.

Half-life: 1.48 hr.

TIME/ACTION PROFILE (plasma concentrations)

ROUTEONSETPEAKDURATION
IVunknownunknownunknown

Contraindication/Precautions

Contraindicated in:

  • None.

Use Cautiously in:

  • OB: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus;
  • Lactation: Safety not established;
  • Rep: Women of reproductive potential;
  • Pedi: Safety and effectiveness not established.

Adverse Reactions/Side Effects

CNS: headache

CV: hypotension, peripheral edema

GU: urinary tract infection

MS: muscle spasms, pain

Resp: dyspnea

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), fatigue, fever

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None noted.

Route/Dosage

Intradialytic: (Adults) Add one 5–mL ampule to each 2.5 gallons of bicarbonate concentrate or add one powder packet to each 25 gallons of the master bicarbonate mix.

Availability

Hemodialysis powder packet: 272 mg/pkt

Hemodialysis solution: 27.2 mg/5 mL

Assessment

  • Monitor for signs and symptoms of hypersensitivity reactions (shock, clinically significant hypotension, loss of consciousness, and/or collapse) during and after dialysis until clinically stable. Treat symptomatically.

Lab Test Considerations:

Measure iron levels on pre-dialysis blood samples; post-dialysis serum iron parameters may overestimate serum iron and transferrin saturation.

Potential Diagnoses

Implementation

  • Ampules appear slightly yellow-green in color. Add only to bicarbonate concentrate not to acid concentrate mixtures. Final concentration in final hemodialysate is 2 micromolar (110 mcg/L). Ampules can be added to bicarbonate mixture in a ratio of one 5–mg ampule/each 2.5 gallons or one 50–mg ampule/25 gallons. Powder can be added to bicarbonate mixture in a ratio of 1 packet/25 gallons. Use mixtures within 24 hr of mixing.

Patient/Family Teaching

  • Explain purpose of medication to patient.
  • Instruct patient to notify health care professional immediately if signs and symptoms of hypersensitivity reactions (rash, itching, dizziness, lightheadedness, swelling, breathing problems) occur.
  • Advise female patient to use effective contraception during and for at least 2 wks after completion of therapy. Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

Maintenance of hemoglobin levels.

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