Iron deficiency is an important clinical concern in chronic kidney disease (CKD), giving rise to ... more Iron deficiency is an important clinical concern in chronic kidney disease (CKD), giving rise to iron-deficiency anemia and impaired cellular function. Oral supplementation, in particular with ferrous salts, is associated with a high rate of gastrointestinal side effects and is poorly absorbed, a problem that is avoided with intravenous iron. The most stable intravenous iron complexes (eg, iron dextran, ferric carboxymaltose, ferumoxytol, and iron isomaltoside 1000) can be given in higher single doses and more rapidly than less stable preparations (eg, sodium ferric gluconate). Iron complexes that contain dextran or dextran-derived ligands can cause dextran-induced anaphylactic reactions, which cannot occur with dextran-free preparations such as ferric carboxymaltose and iron sucrose. Test doses are advisable for conventional dextran-containing compounds. Iron supplementation is recommended for all CKD patients with anemia who receive erythropoiesis-stimulating agents, whether or no...
The efficacy of a single dose of 800 mg resp. 1600 mg iron in the form of an intramuscularly admi... more The efficacy of a single dose of 800 mg resp. 1600 mg iron in the form of an intramuscularly administrable iron (III)-dextran complex (Anaemex, CAS 9004-66-4) has been tested. On 3 groups of 13 calves each, 0 ml (comparing group), 4 ml resp. 8 ml iron dextran 20% have been applied. All calves received iron-containing food during the test period of 10 weeks. At the beginning of the therapy, 5 weeks and 8 weeks after application, the parameters: weight, hemoglobin, erythrocytes, hematocrit, mean corpuscular hemoglobin (MCH), MCH concentration, mean corpuscular volume, plasma protein, fibrinogen, leukocytes and serum iron were measured. After 10 weeks the dead weight has been determined and the spleen of some calves tested histologically. The study shows that, by the administration of 1600 mg iron as a depot injection, a better growth results with the same quality of veal. The red-coloring of the veal was not significantly different from that of the comparing group. The histological fi...
The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period... more The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period crossover, isotope efficacy study. Twenty-two patients with iron-deficiency anemia were enrolled in the study. The study consisted of two treatment phases of 15 days each, including blood sample measurements for Fe-59 activity. The 2 treatments were given orally. Treatment A was Fe-59 labeled iron(III)-hydroxide polymaltose complex (IPC, Maltofer), equivalent to 100 mg elemental iron given orally, and Treatment B consisted of Treatment A combined with 600 mg aluminium hydroxide (CAS 21645-51-2) (10 ml). No differences between the two treatment groups with regard to the erythrocyte uptake were found, and thus IPC can be used with aluminium hydroxide, if necessary.
The study was carried out as an open-label, but laboratory-blind, single-dose, single-centre, ran... more The study was carried out as an open-label, but laboratory-blind, single-dose, single-centre, randomized, two-period crossover study. Twenty-two patients with iron deficiency anemia completed the study. The study consisted of two treatment phases of 36 h, separated by a washout period of between 6 and 14 days. The two treatments were given orally. The reference treatment was tetracycline (CAS 60-54-8) alone (2 x 250 mg capsules) and the test treatment was iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) together with tetracycline (2 x 250 mg capsules).
The following review of iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) shows that iron ... more The following review of iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) shows that iron is significantly bioavailable after oral administration, especially in iron-deficient subjects. Numerous clinical trials in men, women, children and infants have shown that IPC is effective in treating iron deficiency anaemia (IDA). Due to its kinetic properties, IPC is best given with meals, and probably in an iron dose slightly higher than that of the classical iron salts. In terms of acceptance and patient compliance, IPC presents a clear advantage over ferrous salts. Many studies have shown a lower rate of treatment interruption with IPC than with ferrous salts. This is usually associated with a lower incidence of adverse events related to the upper gastro intestinal tract.
This paper reports a study of the pharmacokinetics of ferrous sulphate and ferric-hydroxide-polym... more This paper reports a study of the pharmacokinetics of ferrous sulphate and ferric-hydroxide-polymaltose complex (Hw 6400, Ferrum Hausmann) administered orally and intravenously to anaemic and non-anaemic rats of both sexes. Radiolabelled ferrous sulphate and ferric-hydroxide-polymaltose complex was used to study iron utilization after oral administration. Measurements of radioactivity in serum, packed red cells, whole blood, liver, kidney, spleen, bone and in some cases in the gastrointestinal tract were made following a range of dosages between 0.84 and 41.9 mg Fe/kg. No significant difference in bioavailability or iron utilization was found between the two iron preparations. Pharmacokinetic measurements following i.v. administration showed different distribution volumes, iron clearance and elimination constants for the two preparations. This difference in pharmacokinetic behaviour following oral administration, particularly in the case of non-anaemic rats, was confirmed by the obs...
Pharmacokinetic measurements of ferrous sulphate and ferric hydroxide-polymaltose complex on anae... more Pharmacokinetic measurements of ferrous sulphate and ferric hydroxide-polymaltose complex on anaemic and non-anaemic rats have shown different postabsorption serum iron levels, invasion and elimination constants and distribution volumes for the two preparations. But nevertheless the absorption and utilization ratios of iron from both preparations are equal. It is therefore not justified to calculate utilization ratios for chemically different iron preparations on the basis of postabsorption serum iron measurements. Similar pharmacokinetic differences of these two iron preparations could also be found in clinical trials, which means that different serum iron increase results in an equal utilization ratio for both preparations. It is clear that ferrous sulphate and ferric hydroxide-polymaltose complex must have a different absorption mechanism. The postulated absorption mechanism is in agreement with all the facts known today and does explain the pharmacokinetic difference between the...
Iron deficiency is an important clinical concern in chronic kidney disease (CKD), giving rise to ... more Iron deficiency is an important clinical concern in chronic kidney disease (CKD), giving rise to iron-deficiency anemia and impaired cellular function. Oral supplementation, in particular with ferrous salts, is associated with a high rate of gastrointestinal side effects and is poorly absorbed, a problem that is avoided with intravenous iron. The most stable intravenous iron complexes (eg, iron dextran, ferric carboxymaltose, ferumoxytol, and iron isomaltoside 1000) can be given in higher single doses and more rapidly than less stable preparations (eg, sodium ferric gluconate). Iron complexes that contain dextran or dextran-derived ligands can cause dextran-induced anaphylactic reactions, which cannot occur with dextran-free preparations such as ferric carboxymaltose and iron sucrose. Test doses are advisable for conventional dextran-containing compounds. Iron supplementation is recommended for all CKD patients with anemia who receive erythropoiesis-stimulating agents, whether or no...
The efficacy of a single dose of 800 mg resp. 1600 mg iron in the form of an intramuscularly admi... more The efficacy of a single dose of 800 mg resp. 1600 mg iron in the form of an intramuscularly administrable iron (III)-dextran complex (Anaemex, CAS 9004-66-4) has been tested. On 3 groups of 13 calves each, 0 ml (comparing group), 4 ml resp. 8 ml iron dextran 20% have been applied. All calves received iron-containing food during the test period of 10 weeks. At the beginning of the therapy, 5 weeks and 8 weeks after application, the parameters: weight, hemoglobin, erythrocytes, hematocrit, mean corpuscular hemoglobin (MCH), MCH concentration, mean corpuscular volume, plasma protein, fibrinogen, leukocytes and serum iron were measured. After 10 weeks the dead weight has been determined and the spleen of some calves tested histologically. The study shows that, by the administration of 1600 mg iron as a depot injection, a better growth results with the same quality of veal. The red-coloring of the veal was not significantly different from that of the comparing group. The histological fi...
The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period... more The study was carried out as an open-label, laboratory-blind, single-dose, randomized, two-period crossover, isotope efficacy study. Twenty-two patients with iron-deficiency anemia were enrolled in the study. The study consisted of two treatment phases of 15 days each, including blood sample measurements for Fe-59 activity. The 2 treatments were given orally. Treatment A was Fe-59 labeled iron(III)-hydroxide polymaltose complex (IPC, Maltofer), equivalent to 100 mg elemental iron given orally, and Treatment B consisted of Treatment A combined with 600 mg aluminium hydroxide (CAS 21645-51-2) (10 ml). No differences between the two treatment groups with regard to the erythrocyte uptake were found, and thus IPC can be used with aluminium hydroxide, if necessary.
The study was carried out as an open-label, but laboratory-blind, single-dose, single-centre, ran... more The study was carried out as an open-label, but laboratory-blind, single-dose, single-centre, randomized, two-period crossover study. Twenty-two patients with iron deficiency anemia completed the study. The study consisted of two treatment phases of 36 h, separated by a washout period of between 6 and 14 days. The two treatments were given orally. The reference treatment was tetracycline (CAS 60-54-8) alone (2 x 250 mg capsules) and the test treatment was iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) together with tetracycline (2 x 250 mg capsules).
The following review of iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) shows that iron ... more The following review of iron(III)-hydroxide polymaltose complex (IPC, Maltofer®) shows that iron is significantly bioavailable after oral administration, especially in iron-deficient subjects. Numerous clinical trials in men, women, children and infants have shown that IPC is effective in treating iron deficiency anaemia (IDA). Due to its kinetic properties, IPC is best given with meals, and probably in an iron dose slightly higher than that of the classical iron salts. In terms of acceptance and patient compliance, IPC presents a clear advantage over ferrous salts. Many studies have shown a lower rate of treatment interruption with IPC than with ferrous salts. This is usually associated with a lower incidence of adverse events related to the upper gastro intestinal tract.
This paper reports a study of the pharmacokinetics of ferrous sulphate and ferric-hydroxide-polym... more This paper reports a study of the pharmacokinetics of ferrous sulphate and ferric-hydroxide-polymaltose complex (Hw 6400, Ferrum Hausmann) administered orally and intravenously to anaemic and non-anaemic rats of both sexes. Radiolabelled ferrous sulphate and ferric-hydroxide-polymaltose complex was used to study iron utilization after oral administration. Measurements of radioactivity in serum, packed red cells, whole blood, liver, kidney, spleen, bone and in some cases in the gastrointestinal tract were made following a range of dosages between 0.84 and 41.9 mg Fe/kg. No significant difference in bioavailability or iron utilization was found between the two iron preparations. Pharmacokinetic measurements following i.v. administration showed different distribution volumes, iron clearance and elimination constants for the two preparations. This difference in pharmacokinetic behaviour following oral administration, particularly in the case of non-anaemic rats, was confirmed by the obs...
Pharmacokinetic measurements of ferrous sulphate and ferric hydroxide-polymaltose complex on anae... more Pharmacokinetic measurements of ferrous sulphate and ferric hydroxide-polymaltose complex on anaemic and non-anaemic rats have shown different postabsorption serum iron levels, invasion and elimination constants and distribution volumes for the two preparations. But nevertheless the absorption and utilization ratios of iron from both preparations are equal. It is therefore not justified to calculate utilization ratios for chemically different iron preparations on the basis of postabsorption serum iron measurements. Similar pharmacokinetic differences of these two iron preparations could also be found in clinical trials, which means that different serum iron increase results in an equal utilization ratio for both preparations. It is clear that ferrous sulphate and ferric hydroxide-polymaltose complex must have a different absorption mechanism. The postulated absorption mechanism is in agreement with all the facts known today and does explain the pharmacokinetic difference between the...
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