Difference Between Iron Sucrose and Ferric Carboxymaltose

The key difference between iron sucrose and ferric carboxymaltose is that iron sucrose has a limited dose per sitting, whereas ferric carboxymaltose has a comparatively high dose per sitting.

Iron supplements can come in various forms, like iron salts and iron pills. There are also various different formulations that are useful in treating and preventing iron deficiency which includes iron deficiency anemia. However, iron supplements can result in several side effects, including constipation, abdominal pain, dark stool, and diarrhea. The two major administrations methods of iron supplements include oral administration and injection.

CONTENTS

1. Overview and Key Difference
2. What is Iron Sucrose 
3. What is Ferric Carboxymaltose 
4. Side by Side Comparison – Iron Sucrose vs Ferric Carboxymaltose in Tabular Form
5. Summary

What is Iron Sucrose?

Iron sucrose is a treatment for iron deficiency anemia which includes intravenous administration of iron. The active ingredient of this iron supplement, iron sucrose, can replace the iron in the blood in order to foster the production of red blood cells in patients having chronic kidney disease. The trade name of this iron supplement is Venofer.

The chemical formula for the iron sucrose substance is C₁₂H₂₉Fe₅Na₂O₂₃. It has a molar mass of 866.54 g/mol. A molecule of iron sucrose can be named as a polymer molecule having two major molecules: sucrose molecule and iron(III) hydroxide. In commercial-scale iron sucrose, we can observe that these two molecules occur in a solution together. However, these molecules occur separately, not bound to each other. Moreover, we can name iron sucrose as a type II complex because it has two oxygen atoms bonded to each iron atom. When we are using this substance for medical purposes, the iron complex occurs in a polymerized state where sucrose molecules also combine with each other, forming a larger polysaccharide.

Iron sucrose appears as a dark brown liquid solution. When considering the route of administration, it is administrated only through the intravenous method. Furthermore, this iron supplement is useful only when a patient with iron deficiency anemia cannot be treated using oral iron supplements. Around 80% of patients tend to respond to this drug. Usually, iron sucrose supplement contains about 20 mg of iron per 1 mL of the solution. An adult can typically tolerate up to 600 mg of iron sucrose per week. Once a patient has received iron sucrose, it is transferred to ferritin. Ferritin is the normal iron storage protein in our body. Then this complex get is broken down in the liver, spleen and bone marrow, forming iron, which is then stored in our body for later use or is taken up the plasma. Then the plasma can transfer this iron to hemoglobin which can eventually increase red blood cell production.

However, there can be some side effects of iron sucrose, including headache, blurry vision, fever, dizziness, chest pain, difficulty in breathing, unusual heartbeat, unusual tingling, sudden weight changes, swelling, and bloating.

What is Ferric Carboxymaltose?

Ferric carboxymaltose is a type of iron supplement that is given through injection or infusion where the oral intake of iron is impossible for a particular patient. It is commercially available as a dark brown solution. This solution is non-transparent, and it is an aqueous solution.

There are three main occasions where we can use this iron supplement instead of oral iron supplements; when oral iron preparations are ineffective when oral iron preparations cannot be used, and when there is a clinical need for the delivery of iron rapidly. This iron supplement must not be administrated through the intramuscular method or subcutaneous method. The trade name for this iron supplement is Ferinject.

The most common side effects related to ferric carboxymaltose include headache, dizziness, flushing, hypertension, and nausea. There are some uncommon side effects as well, which include hypersensitivity, anxiety, hypotension, dyspnoea, vomiting, abdominal pain, constipation, diarrhea, and rashes.

What is the Difference Between Iron Sucrose and Ferric Carboxymaltose?

Both iron sucrose and ferric carboxymaltose are types of iron supplements that are important in treating iron-deficiency anemia. These supplements are useful when the oral administration of iron is impossible. Iron sucrose is a treatment for iron deficiency anemia which includes intravenous administration of iron, while ferric carboxymaltose is a type of iron supplement that is given through injection or infusion where the oral intake of iron is impossible for a particular patient. The key difference between iron sucrose and ferric carboxymaltose is that iron sucrose has a limited dose per sitting, whereas ferric carboxymaltose has a comparatively high dose per sitting.

The below infographic lists the differences between iron sucrose and ferric carboxymaltose in tabular form.

Summary – Iron Sucrose vs Ferric Carboxymaltose

Both iron sucrose and ferric carboxymaltose are types of iron supplements that are important in treating iron-deficiency anemia. These supplements are useful when the oral administration of iron is impossible. The key difference between iron sucrose and ferric carboxymaltose is that iron sucrose has a limited dose per sitting whereas ferric carboxymaltose has a comparatively high dose per sitting.

Reference:

1. “Ferinject (Ferric Carboxymaltose).” Ferinject (Ferric Carboxymaltose) – Summary of Product Characteristics (SmPC) – (Emc), Available here.

Image Courtesy:

1. “Iron sucrose IV drip” By Smokefoot – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Iron Sucrose Structure” By Rauscha – Own work (CC BY-SA 4.0) via Commons Wikimedia