FDA-filed SPL labeling · retrieved through openFDA

Ferric Carboxymaltose Injection

Ferric carboxymaltose injection is an intravenous iron replacement used to treat iron deficiency anemia and iron deficiency in adults with heart failure.

Brand name Injectafer
Drug classes Parenteral Iron Replacement
Rx Form 1 Route Intravenous
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 5 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveSep 2, 2026
Clinical labels in scope 5
AvailabilityRx
Earliest approval/marketing year 2013
FDA-listed product records 22
Boxed warningYes
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Ferric Carboxymaltose Injection at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Ferric carboxymaltose injection is a fast-acting intravenous iron treatment for iron deficiency anemia and iron deficiency in heart failure, given when oral iron isn't tolerated or hasn't worked. The biggest risk to know about is a serious drop in blood phosphate levels, which requires monitoring — especially if you need repeat doses. Always have these infusions in a medical setting where allergic reactions can be treated immediately.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert

Ferric carboxymaltose injection can cause severely low blood phosphate levels (hypophosphatemia) — a serious risk that can lead to hospitalization, bone softening, and fractures. This can happen even in people who had normal phosphate levels before treatment and had no obvious risk factors. It is most common after repeated courses of the medication.

Watch for warning signs of low phosphate: unusual fatigue, muscle weakness or pain, bone or joint pain, or unexplained bone fractures. Report any of these to your doctor right away. If you need a repeat course of treatment — especially within three months — your doctor should check your phosphate levels first and correct any deficiency before proceeding.

Read the full warning on DailyMed →

📖 Ferric Carboxymaltose Injection: Patient Information Guide

A plain-language walkthrough of Ferric Carboxymaltose Injection — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Ferric carboxymaltose injection is an intravenous iron replacement approved for the following conditions:

  • Iron deficiency anemia (IDA) in adults and children aged 1 year and older who cannot tolerate oral iron or have not had a satisfactory response to it
  • Iron deficiency anemia in adults with non-dialysis dependent chronic kidney disease
  • Iron deficiency in adults with heart failure (New York Heart Association class II or III) to improve exercise capacity
⚙️How it works

Ferric carboxymaltose is iron bound to a carbohydrate molecule called carboxymaltose, which acts as a protective carrier. When infused into the bloodstream, the complex releases iron in a controlled way. That iron is then taken up by red blood cells and stored in the body — restoring iron levels and supporting the production of healthy, oxygen-carrying red blood cells.

💊How it's taken

Ferric carboxymaltose injection is given intravenously (into a vein) by a healthcare professional. It is not taken by mouth. The number of doses and timing depend on your weight, hemoglobin level, and the condition being treated.

  • For iron deficiency anemia, it is generally given in two doses at least 7 days apart
  • For iron deficiency with heart failure, the schedule is more individualized — your doctor will determine timing based on your hemoglobin and iron levels
  • Treatment can be repeated if your condition returns
  • Always follow the schedule your prescriber gives you; do not adjust doses on your own
🤒Side effects — in detail

The most common side effects in adults include:

  • Nausea
  • High blood pressure (hypertension) — usually a temporary spike right after dosing
  • Flushing or feeling hot
  • Injection site reactions (pain, redness, swelling, or brown skin discoloration)
  • Dizziness
  • Low blood phosphate (hypophosphatemia) — can be serious; see warnings
  • Headache
  • Vomiting

In children, the most commonly reported side effects include low phosphate, injection site reactions, rash, headache, and vomiting. Seek immediate medical help if you notice signs of a severe allergic reaction — difficulty breathing, swelling, sudden drop in blood pressure, or loss of consciousness.

⚠️Warnings & precautions
  • Low phosphate levels (hypophosphatemia): This is the most serious risk flagged by the FDA with a boxed warning. Phosphate can drop to dangerous levels — causing bone softening (osteomalacia) and fractures — even in people who started with normal levels. Watch for fatigue, muscle weakness, bone or joint pain, or fractures, and report these immediately.
  • Severe allergic reactions (anaphylaxis): Life-threatening reactions have occurred. You must receive this medication in a setting where emergency treatment is immediately available, and you'll be monitored for at least 30 minutes after each dose.
  • High blood pressure: Temporary blood pressure spikes — sometimes with flushing, dizziness, or nausea — occur in some patients shortly after dosing and usually resolve within 30 minutes.
  • Lab test interference: In the 24 hours after infusion, blood iron tests may read falsely high. Make sure any lab drawing blood during that window knows you received this medication.
  • Pregnancy: Serious allergic reactions during infusion can cause fetal heart rate drops (bradycardia), especially in the second and third trimester. Discuss risks carefully with your doctor.
🔀What it interacts with

The FDA label for ferric carboxymaltose injection does not describe specific drug, food, or supplement interactions. However, inform your doctor and pharmacist about all medications you take, especially:

  • Any medications that affect kidney tubule function — these may increase the risk of low phosphate levels
  • Any other iron supplements or IV iron products — your doctor needs the full picture to dose safely

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Allergy history: Do not use if you have had a serious allergic reaction to ferric carboxymaltose or any of its components — this is a contraindication
  • Low phosphate: Pre-existing hypophosphatemia must be corrected before starting treatment
  • Risk factors for low phosphate: Tell your doctor if you have gastrointestinal malabsorption, inflammatory bowel disease, vitamin D deficiency, hyperparathyroidism, malnutrition, hereditary hemorrhagic telangiectasia (HHT), or take medications that affect kidney tubule function
  • Pregnancy: There is a risk of serious allergic reactions that could affect the fetus; discuss risks and benefits with your doctor. Untreated iron deficiency anemia in pregnancy also carries risks
  • Breastfeeding: Iron can pass into breast milk; discuss with your doctor whether to continue breastfeeding
  • Children: Approved for IDA in children aged 1 year and older; safety and effectiveness have not been established in children under 1 year or for heart failure in children
  • Older adults: Clinical studies included many patients 65 and over with no overall safety differences found, though individual sensitivity cannot be ruled out
🚑If you take too much

Too much ferric carboxymaltose can cause iron to build up in the body's storage organs — a condition called hemosiderosis — which can affect joints and mobility. There are also reports of bone problems (hypophosphatemic osteomalacia) with repeated high-dose courses. If overdose is suspected, contact the Poison Help line at 1-800-222-1222 or seek immediate medical attention.

📡Pharmacodynamics — effects in the body

After infusion, iron from ferric carboxymaltose is taken up by red blood cells to support oxygen transport. In people with iron deficiency, studies using imaging technology showed that 91% to 99% of the infused iron was incorporated into red blood cells within 24 days. In people with kidney-related anemia, red blood cell uptake ranged from 61% to 84% over the same period — still a meaningful correction of iron status.

🔬Pharmacokinetics — how your body processes it

After an intravenous dose, iron levels in the blood peak quickly — within about 15 minutes to just over an hour in adults. The iron is then rapidly cleared from the bloodstream, with a half-life (the time for blood levels to drop by half) of roughly 7 to 12 hours in adults and about 9.7 hours in children. Very little iron is eliminated through the kidneys; instead, it is redistributed and stored in the body's tissues. In children aged 1 to 17, peak blood levels are reached in about 7 minutes after the dose.

📦How to store it

Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Do not freeze.

📄 Written from Ferric Carboxymaltose Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Ferric Carboxymaltose Injection — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is ferric carboxymaltose injection used for?
It's an iron treatment given by IV — directly into a vein. It's used when your iron levels are too low and oral iron tablets haven't worked or you can't tolerate them. It's approved for iron deficiency anemia in adults and kids aged 1 and up, and separately for adults with heart failure who have iron deficiency and need help improving their ability to exercise.
What side effects should I expect after my infusion?
The most common ones are nausea, flushing or feeling hot, some dizziness, headache, and reactions at the IV site like redness or mild discomfort. A temporary rise in blood pressure right after the infusion is also fairly common and usually settles within 30 minutes. Let your nurse know if anything feels off during or right after the infusion — you'll be watched closely for at least half an hour.
I've heard this can cause problems with phosphate levels. Should I be worried?
This is actually the biggest warning on this medication, so it's worth knowing about. In some people — even those with normal phosphate levels to start — ferric carboxymaltose can cause phosphate to drop significantly. This can lead to bone pain, muscle weakness, and even fractures. It's more likely to happen with repeated courses of treatment. Your doctor should check your phosphate before giving you another round, and you should report any unusual bone pain, fatigue, or muscle weakness right away.
How is this medication given — do I have to stay at the clinic?
Yes, it's given intravenously by a healthcare professional, so you'll need to be at a clinic, infusion center, or hospital. It's usually given as a slow injection or drip into your vein. You'll also need to stay for monitoring for at least 30 minutes after each dose in case of a reaction. Typically you'll receive two doses at least a week apart, though the exact schedule depends on your weight and condition.
Is it safe to receive this if I'm pregnant?
Your doctor will weigh the risks and benefits carefully. Untreated iron deficiency anemia in pregnancy does carry real risks — including preterm delivery and low birth weight — so treatment may be necessary. The main concern with the infusion itself is that a serious allergic reaction, while rare, could affect your baby's heart rate, especially in the second and third trimester. Make sure your care team knows you're pregnant so they can monitor you closely.
Can this medication affect my blood test results?
Yes — in the 24 hours after your infusion, standard blood tests that measure iron levels can read falsely high, because the lab may be picking up iron from the medication itself rather than just your natural levels. Make sure anyone drawing blood after your infusion knows you just received ferric carboxymaltose, so they can interpret the results correctly.
Is Ferric Carboxymaltose Injection available over the counter?
Ferric Carboxymaltose Injection is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Ferric Carboxymaltose Injection first available?
Ferric Carboxymaltose Injection has been available in the United States since at least 2013, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Ferric Carboxymaltose Injection?
Ferric Carboxymaltose Injection is supplied by 3 manufacturers listed in the FDA NDC Directory, including American Regent, Inc., Mylan Institutional LLC, Sandoz, Inc..

💬 Answers drafted from Ferric Carboxymaltose Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Ferric Carboxymaltose Injection comes

Ferric Carboxymaltose Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Injection

Into a vein
Brands Injectafer
How this form is used
What it may be used for
  • Treats iron deficiency anemia in adults and children aged 1 year and older who cannot tolerate or have not responded to oral iron
  • Treats iron deficiency anemia in adults with non-dialysis dependent chronic kidney disease
  • Treats iron deficiency in adults with heart failure (NYHA class II/III) to improve exercise capacity
Important instructions
  • Given intravenously by a healthcare professional as a slow IV push or diluted infusion; never self-administered
  • Typically given in two doses separated by at least 7 days — exact schedule depends on your weight, hemoglobin, and condition
  • Patients are monitored for at least 30 minutes after each infusion for signs of allergic reaction or blood pressure changes
  • Avoid extravasation (iron leaking outside the vein) — it can cause long-lasting brown skin discoloration at the injection site
Available strengths 1 strength
22 FDA-listed product records

📊 Ferric Carboxymaltose Injection across the U.S. market

How Ferric Carboxymaltose Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
3
Manufacturers
2
Brand names
22
FDA-listed product records
2013
First marketed
American Regent, Inc.55%
Mylan Institutional LLC36%
Sandoz, Inc.9%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Ferric Carboxymaltose Injection is used

A general measure of how commonly Ferric Carboxymaltose Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Ferric Carboxymaltose Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

37,991
Medicaid prescriptions filled (Q1–Q4 2025)
$36.1M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Ferric Carboxymaltose Injection prescribed? Of the 1,596 medications we measure, Ferric Carboxymaltose Injection ranks #686 by Medicaid prescriptions — more than 57% of them.

Where Ferric Carboxymaltose Injection ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Ferric Carboxymaltose Injection product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 15 mL / 50 mg/mL injection is the most-dispensed Ferric Carboxymaltose Injection product — about 100% of these Medicaid prescriptions.

15 ML ferric carboxymaltose 50 MG/ML Injection Most dispensed

37,812 Medicaid prescriptions (Q1–Q4 2025) 100% of Ferric Carboxymaltose Injection prescriptions shown $36M gross reimbursement (before rebates) ≈ $952 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1435169

2 ML ferric carboxymaltose 50 MG/ML Injection

179 Medicaid prescriptions (Q1–Q4 2025) <1% of Ferric Carboxymaltose Injection prescriptions shown $103,571 gross reimbursement (before rebates) ≈ $579 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2602296

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ferric Carboxymaltose Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 2 listed Ferric Carboxymaltose Injection NDCs with Medicaid activity.

🔍 Compare Ferric Carboxymaltose Injection products

A representative set of FDA-listed product records for Ferric Carboxymaltose Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category Details
💊Injection
50 mg/mL Intravenous American Regent, Inc. × 12 listings NDA View NDC →
50 mg/mL Intravenous Mylan Institutional LLC × 8 listings ANDA View NDC →
50 mg/mL Intravenous Sandoz, Inc. × 2 listings NDA AUTHORIZED GENERIC View NDC →

Showing 22 of 22 products — FDA National Drug Code Directory. See every product, package size and price: browse all 22 Ferric Carboxymaltose Injection NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Ferric Carboxymaltose Injection RxCUI 1433693 1 dose form · 3 strengths

Look up RxCUI 1433693 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Injectafer

🏭 Manufacturers & labelers

American Regent, Inc. 12 Mylan Institutional LLC 8 Sandoz, Inc. 2

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Sep 2, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Ferric Carboxymaltose Injection.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Ferric Carboxymaltose Injection after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
5
NDC products indexed
22
Distinct labelers/manufacturers represented
3
Linked representative label
Sandoz, Inc.
Linked label effective
Sep 2, 2026
Composite sections available
21
Linked SPL Set ID
bfdf7447-62e4-48ca-b903-11cb3b211064
Linked SPL Document ID
4228287d-2252-46bf-a52b-5b2165a702e1
Open the linked representative label on DailyMed ↗
NDC package records associated with this linked SPL 1

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 5 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Sandoz, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.