Ferricure

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Ferricure

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ferricure

Property Description
Active Ingredient Iron Sucrose Complex
Form Solution for injection/infusion
Pharmacological Class Parenteral Iron Replacement, Antianemic Agent
General Purpose Replenishment of body iron stores
Origin Synthetic/Chemically Derived

What Type of Medicine Is Ferricure?

Ferricure is a prescription-only pharmaceutical preparation that belongs to the class of antianemic agents known specifically as parenteral iron replacement preparations. Its active substance is Iron Sucrose, a compound with recognized clinical efficacy for treating iron deficiency. As a therapeutic agent, it is recognized as an effective and safe medicine within basic health systems. The formulation is strictly an injectable solution or concentrate for infusion, requiring intravenous (IV) administration under medical supervision. The categorization as a parenteral agent differentiates it from common oral supplements by bypassing the digestive system entirely, ensuring direct systemic delivery.


Composition and Chemical Identity of Iron Sucrose

The active component, Iron Sucrose (chemically known as iron saccharate), is a synthetic iron carbohydrate complex. Its structure is defined by a core of polynuclear iron(III)-hydroxide stabilized by a protective sucrose ligand. This specific, high molecular weight configuration allows the iron complex to be classified as a nanomedicine, characterized by a controlled biodistribution profile. This stability is crucial, as it allows for the administration of therapeutic iron doses while minimizing the risk associated with the formation of unbound, highly reactive iron in the bloodstream, maximizing the potential for efficient iron transfer. The complex is designed to be analogous to ferritin, the body's natural iron storage protein.


General Purpose: Why Parenteral Iron Is Used

The general purpose of Ferricure is to rapidly achieve effective iron replenishment in a typical neutral use scenario, such as when a patient is unable to achieve sufficient iron levels through dietary changes or oral iron supplements. This function is critical for individuals whose body cannot effectively absorb sufficient iron through the digestive system or those who require rapid iron mobilization. By directly supplying the essential mineral, Ferricure supports the body's ability to accelerate the production of hemoglobin and red blood cells, addressing the deficiency with high and predictable bioavailability.

Regulatory References

  1. WHO Model List of Essential Medicines

What side effects are possible with Ferricure?

Possible Side Effects and Safety Information

Ferricure (Iron Sucrose) has a safety profile established through regulatory review, detailing its known adverse reactions and safety restrictions. The official information is structured into distinct safety domains to communicate the drug's risk profile in a neutral, label-based manner.


Serious Adverse Reactions and Immediate Risk

The most critical safety consideration is the risk of serious hypersensitivity reactions, including anaphylactic-type reactions, which have been reported as life-threatening or fatal. These reactions may include shock or collapse and are noted to occur following the first dose or subsequent doses, often within the first few minutes of administration or up to 30 minutes after completion.

Frequency-Classified Adverse Reactions

Adverse reactions are classified based on frequency and grouped by System-Organ Class. Common reactions (occurring in 2% of adult patients) primarily affect the vascular, gastrointestinal, and nervous systems, including Hypotension (low blood pressure), Headache, Nausea, Vomiting, and Injection Site Reactions.

System-Organ Class (SOC) Common Adverse Reactions
Vascular Disorders Hypotension
Nervous System Disorders Headache, Dizziness
Gastrointestinal Disorders Nausea, Vomiting, Diarrhea

Population-Specific Safety Considerations and Restrictions

Official labeling addresses specific populations: use during pregnancy is associated with the risk of fetal bradycardia. Furthermore, Ferricure is contraindicated (should not be used) in individuals with evidence of Iron Overload (such as hemosiderosis or hemochromatosis) or anemia that is not caused by iron deficiency. All patients require periodic monitoring of iron parameters to assess for the development of iron overload.

Overdose and Emergency Response

Overdose of Ferricure (Iron Sucrose Complex) is documented in two principal areas by regulatory authorities: the cumulative risk of iron overload and the acute risk of severe administration reactions. Excessive cumulative therapy can lead to iatrogenic hemosiderosis (iron overload), and prevention of this outcome requires the periodic monitoring of iron parameters by a healthcare professional.

Acute manifestations are often related to the rate or total dose administered and include clinically significant hypotension and other signs of intolerance. Urgent medical help is required for serious hypersensitivity reactions, which have been reported as potentially life-threatening and may present as shock, collapse, or loss of consciousness.

The official response to these acute events mandates that the infusion must be stopped immediately upon the occurrence of intolerance or hypersensitivity signs, and regulatory guidance specifies that emergency personnel and therapies must be readily available at the time of administration. Treatment for overdosage is defined as symptomatic and supportive. Chelation therapy, such as Deferoxamine, is typically reserved for severe, life-threatening cases associated with clinical deterioration or severe metabolic acidosis.

Therapeutic Uses of Ferricure

What Ferricure Treats: Main Uses and Benefits

This treatment is commonly used to help with the pronounced and debilitating fatigue and low energy that arise directly from Iron Deficiency Anemia (IDA). By achieving iron replenishment, the medication supports the body's ability to produce oxygen-carrying red blood cells, which helps alleviate the chronic symptom burden. This contributes to easing the overall symptom load and supports general well-being.

Ferricure is considered relevant for application in specific chronic settings, notably for iron deficiency in patients with Chronic Kidney Disease (CKD) and symptomatic Chronic Heart Failure (CHF). The medication may be part of symptomatic management when inflammation can hinder iron utilization, or when patients are unable to adequately absorb or tolerate standard oral iron therapy. The primary conditions for which it is applied include Iron Deficiency Anemia, iron deficiency in CKD across all stages, and iron deficiency associated with Chronic Heart Failure.

“It assists with maintaining functional stability and helps patients cope more steadily with symptom fluctuations.”

Quick Fact: Relief for Severe Fatigue Ferricure is commonly used to help with severe and persistent fatigue, low energy, and poor exercise tolerance, which are common symptoms that interfere with daily functioning in iron-deficient states.

Eligibility and Restrictions for Use

Who Can and Cannot Use Ferricure?

Eligibility for Ferricure is determined by regulatory-mandated criteria, primarily focusing on absolute contraindications and specific population limitations. This information is derived strictly from official government regulatory documents.


Absolute Non-Eligibility (Contraindications)

The medicine must not be used by individuals with a known serious hypersensitivity to Ferricure or its components. It is also strictly contraindicated for patients diagnosed with iron overload syndromes, such as hemochromatosis, or for those actively receiving repeated blood transfusions.


Specific Eligibility Restrictions

Population Category Regulatory Status
Pediatric Patients Safety and effectiveness are typically not established for the majority of children and adolescents.
Pregnancy Use requires a careful benefit-risk assessment and is generally restricted to the second and third trimesters.
Prior Treatment Eligibility is often restricted to adults who have had an unsatisfactory response or intolerance to prior oral iron treatments.
Hepatic Function Use may be restricted or prohibited in cases of decompensated liver disease or where iron overload is suspected.

Note: Ferricure is generally permitted for use in adults (18 and older) who meet the indication criteria and have none of the specified contraindications. These rules define the only eligible populations.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Ferricure's interaction profile is primarily governed by the ability of iron to form complexes in the gut and its involvement in systemic iron metabolism. This necessitates specific separation requirements or avoidance of concomitant use with certain products to prevent reduced efficacy or increased toxicity.

Products Requiring Avoidance (Contraindicated/To Be Avoided)

Interacting Product/Category Practical Constraint/Implication
Intravenous Iron Avoid due to risk of hypotension or collapse from rapid iron release and transferrin saturation.
Dimercaprol Avoid due to documented risk of nephrotoxicity.
Chloramphenicol Avoid as it interferes with erythropoiesis and delays plasma iron clearance.
Methyldopa Avoid concomitant use due to potential antagonism of its hypotensive effect.

Products Requiring Administration Separation

Oral Ferricure reduces the absorption of many orally taken medicines due to chelation, requiring time separation to maintain therapeutic efficacy. These medicines must be administered at least two hours before or after Ferricure:

  • Fluoroquinolone Antibiotics (e.g., ciprofloxacin, moxifloxacin)
  • Bisphosphonates
  • Thyroid Hormones (e.g., levothyroxine)
  • Penicillamine, Entacapone, Levodopa, Mycophenolate

Tetracycline Antibiotics require a separation of two to three hours from Ferricure administration. Food has also been documented to inhibit the uptake of Ferricure, requiring administration on an empty stomach for optimal absorption.

Mechanism of Action

️ Regulated Uptake by the Reticuloendothelial System (RES)

The active substance is delivered as a stable Iron Sucrose Complex, a nanostructure whose architecture leads to rapid clearance by macrophages in the liver and spleen (the RES). This process of regulated cellular uptake and subsequent slow breakdown dictates that iron release occurs intracellularly, minimizing the formation of unbound iron in the blood and channeling the mineral into the physiological transport cycle.


Targeted Mobilization for Hemoglobin Synthesis

Once processed by the RES, the iron is swiftly exported from the macrophages and bound to the circulating protein Transferrin. This efficient delivery mechanism channels the iron to the bone marrow, where it is rapidly taken up by erythroid precursor cells. The resulting influx of substrate overcomes the nutritional limitation that restricts Hemoglobin synthesis and the maturation of new red blood cells.


Mechanism-Driven Physiological Correction

The physiological effect is directly linked to the acceleration of Erythropoiesis (red blood cell production), a process driven by the drug's readily available iron substrate. By providing the essential mineral, the mechanism leads to a systemic increase in Hemoglobin concentration and the replenishment of iron storage pools (Ferritin), which contributes to an increase in the blood’s oxygen-carrying capacity.

Dosage and Administration Information

How to Use Ferricure (Ferric Citrate)

Ferricure (ferric citrate) is an oral medication taken by adults on dialysis to help manage serum phosphorus levels. The following information describes the administration process.

Administration Scope

Feature Administration Guidelines
Route of Administration Oral (tablet, swallowed whole)
Standard Frequency Three times per day (TID)
Timing in Relation to Meals Take with meals
Preparation Tablets must be swallowed whole; do not chew, crush, or break them to avoid discoloration of the mouth and teeth.

Dosing and Procedure

The starting dose is typically 2 tablets taken orally with each of the three daily meals. The total daily dose is adjusted by the prescriber, usually in increments or decrements of 1 to 2 tablets per day, at intervals of one week or longer. The maximum daily dose is 12 tablets.


Specific Administration Rules

  • Missed Dose: If a dose is missed, take it as soon as possible. However, if it is almost time for the next scheduled dose, the missed dose should be skipped; do not double the dose.
  • Drug Separation: Certain oral medications, such as doxycycline, must be taken at least 1 hour before Ferricure. Other drugs, such as ciprofloxacin, must be taken at least 2 hours before or after Ferricure to minimize potential interactions.

This structure ensures the following of the specific process necessary for management, including meal-timing requirements and separation from certain other medications.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Ferricure


Evidence for Use in Iron Deficiency Anemia (IDA) in Chronic Kidney Disease (CKD)

The research base for Ferricure (Iron Sucrose) in patients with iron deficiency anemia (IDA) who also have Chronic Kidney Disease (CKD) is substantial, relying on numerous Randomized Controlled Trials (RCTs) and systematic reviews included in regulatory submissions. These studies were evaluated in research evaluating blood markers and the medicine’s role in iron stores. The main outcomes research examined included changes in key blood markers like Hemoglobin (Hb) and the levels of iron stores, measured by Serum Ferritin and Transferrin Saturation (TSAT). Studies monitored how these markers evolved in observed populations, including patients undergoing hemodialysis (HDD-CKD) and those with non-dialysis-dependent CKD (NDD-CKD).

Findings describe patterns observed in these studies, where changes in measured iron levels and in the dosage requirements for other concurrent anemia treatments, such as Erythropoiesis-Stimulating Agents (ESAs), were reported. Research highlights that changes in the markers used to diagnose and track iron status were reported in the studied patient groups during the study period. Initial treatment phases are characterized by a substantial volume of research, but long-term patient outcomes beyond one to two years are not as thoroughly characterized by large-scale RCTs.

Evidence in Other Iron Deficiency Settings

Ferricure was also studied for use in a range of other clinical situations where a rapid or non-oral method of iron replenishment was required. This includes studies in patients with IDA due to chronic blood loss, those with gastrointestinal disorders, and individuals with severe postpartum anemia. Research has explored its application in iron deficiency associated with Chronic Heart Failure (CHF), even in the absence of anemia. The study types were generally short-term RCTs and observational studies where research examined outcomes related to systemic or functional imbalance.

In these varied populations, the studies monitored the same core hematological markers (Hb, ferritin, TSAT), and also evaluated patient-reported outcomes describing perceived discomfort related to the iron deficiency, such as severe fatigue and functional capacity. Findings describe that a change in iron status was observed across these diverse groups, and some studies reported changes in patient-reported fatigue assessments. However, the evidence for Ferricure specifically remains more fragmented and limited across all non-CKD settings.

Research on Symptom-Focused Outcomes and Specialized Uses

Research has also explored the use of Ferricure for specific neurological and functional symptoms associated with iron deficiency, such as Restless Legs Syndrome (RLS). These studies were typically small, exploratory trials focusing on episodes where symptoms become more noticeable and disruptive to sleep. Outcomes measured were highly specific to the symptom, such as validated RLS severity scales and assessments of sleep quality.

Long-Term Studies and Follow-Up Data

Longer follow-up was explored through large-scale observational studies and comparative trials that monitored outcomes for up to a year or more, particularly in CKD patients. These studies described patterns related to the need for repeated treatment and the maintenance of iron stores. However, the research is ongoing, and long-term effects are not fully established with the same certainty as the short-term physiological changes.

Key Studies & References WHO Model List of Essential Medicines (Iron Sucrose listing)

Frequently Asked Questions (FAQ)

Common questions about Ferricure (FAQ)


Q: What is the biggest difference between Ferricure and other treatments for the same condition?

A: The biggest difference is the route of administration. Official documents state that Ferricure is a parenteral (intravenous) iron replacement, meaning it is delivered directly into the bloodstream. This method is typically used for patients whose iron deficiency cannot be effectively managed with oral iron preparations or who cannot tolerate them.


Q: Is Ferricure meant to be taken long-term?

A: Regulatory documents indicate there is no stated maximum duration. The course of therapy is determined by periodic monitoring of the patient's iron parameters. Because excessive therapy can lead to iron overload (hemosiderosis), a healthcare professional adjusts or stops treatment based on these monitored levels.


Q: What common over-the-counter medicines are known to interact with Ferricure?

A: Regulatory information describes that Ferricure is not recommended for concomitant use with other iron supplements (oral or injectable). Official documents also mention that some oral medications, including certain over-the-counter types like antacids containing Aluminum hydroxide or Calcium carbonate, can interact, potentially reducing the absorption of either drug.


Q: Can Ferricure be taken by someone who is pregnant or breastfeeding?

A: Pregnancy: Official labeling states that use in the first trimester is generally contraindicated or should be avoided. Use during the second and third trimesters is permitted only after a risk assessment is performed by a healthcare professional. Breastfeeding: Official reports confirm that the active substance is present in human milk, but published studies have not reported adverse reactions in breastfed infants following exposure.


Q: Can Ferricure affect mood or sleep?

A: Official labeling lists certain adverse reactions that may affect consciousness, such as dizziness and headache. Although less common, regulatory reports also include instances of confusion or loss of consciousness. These effects should be considered in the context of the medicine's safety profile.


Q: What are the ingredients in Ferricure besides the main active substance?

A: The medicine's active core is the Iron Sucrose complex, which is stabilized by a protective sucrose ligand. The final injectable solution is largely composed of Water for Injection. It may also contain small amounts of Sodium Hydroxide or Hydrochloric Acid to ensure the correct pH balance.


Q: What should I tell my doctor before starting Ferricure?

A: Official warnings describe conditions that must be known by the prescriber before treatment is initiated. This includes a history of reactions to any parenteral iron products (IV iron), any known allergies, and any current signs or history of conditions that involve iron overload (hemosiderosis).


Q: How long does it usually take to notice any effects from Ferricure?

A: The official labeling for this medicine focuses on measurable physiological effects rather than subjective feelings. Regulatory documents state that blood markers like the Hemoglobin ( Hb) level should not be re-assessed no earlier than 4 weeks after the last administration. This timing is necessary to allow for the body's process of red blood cell production and maturation.


Q: Does Ferricure cause any changes to your weight?

A: Changes in weight are not listed among the most common adverse reactions (ge 2%) reported in clinical trials. However, both unusual weight gain or loss have been included in some post-marketing safety reports. These are considered reactions of unknown or rare incidence.


Q: I've heard people talk about a metallic taste; is that a known side effect of Ferricure?

A: Yes, a change in taste (clinically known as dysgeusia) is listed as a reported side effect of this medicine in official documents. Patients may sometimes describe this experience as a metallic taste immediately following administration.


Q: Is it true that Ferricure can change the color of your stool?

A: Official information notes that the medicine may cause localized injection site discoloration if the solution leaks outside the vein. However, changes in stool color (such as darkening) are not listed among the common adverse reactions for the intravenous formulation, though this is a common side effect of oral iron supplements.


Q: Does Ferricure interact with common heartburn medications like antacids?

A: Yes, the official drug interaction lists include medications that contain substances like Aluminum hydroxide or Calcium carbonate, which are common antacid ingredients. These substances can interfere with the oral iron formulation's absorption, or the iron may reduce the antacid's effectiveness.


Q: I feel tired when I take it; is fatigue a known side effect of Ferricure?

A: Unusual tiredness or weakness (asthenia/fatigue) is listed in official documents as a possible adverse reaction. However, fatigue is also a primary symptom of the condition the medicine is treating, and it can be a sign of other complications like a serious allergic reaction.


Q: How soon after starting Ferricure do people typically have follow-up appointments?

A: The timing of follow-up is decided by the prescribing clinician based on individual needs. However, official guidelines for assessing treatment response state that blood marker levels like Hemoglobin ( Hb) should not be re-assessed any sooner than 4 weeks after the final dose.


Q: Does Ferricure have a known risk of dependence or withdrawal?

A: According to official safety and warnings sections across multiple regulatory documents, no risk of dependence or specific withdrawal effects is associated with the use of this medicine.


Q: Can people who are vegetarian or vegan take Ferricure?

A: The active component, Iron Sucrose, is a synthetic iron carbohydrate complex. This means it is chemically derived from iron and sucrose (sugar). The official composition information does not list any animal-derived components that are required to be disclosed as excipients.


Q: What are the most common reasons why Ferricure is discontinued by patients?

A: Official adverse reaction reports list the most common side effects (ge 2%) that may potentially lead to a patient or doctor stopping the medication. These include events like diarrhea, nausea, vomiting, headache, dizziness, and hypotension (low blood pressure).


Q: Does alcohol consumption affect how Ferricure works?

A: Official drug interaction sections do not list any direct interaction between the consumption of alcohol and the way this medicine works in the body.


Q: Is there a maximum time someone can stay on Ferricure?

A: Official documents do not specify a maximum treatment duration. Regulatory information emphasizes that treatment must be continuously monitored by a healthcare professional, with doses adjusted to prevent the serious risk of Iron Overload.


Q: Do most patients who take Ferricure tolerate it well?

A: Official documents detail the most common side effects (ge 2%) that patients may experience, but they do not provide a general statement on overall patient tolerability rates. The experience of side effects can vary widely among individuals.


Q: If I stop taking Ferricure suddenly, will there be any effects?

A: Official safety and warnings sections do not list any specific withdrawal or rebound effects that occur if a patient suddenly stops using this medicine.


Q: Does Ferricure have any warnings about driving or operating machinery?

A: The medicine can cause common side effects such as dizziness and headache. Regulatory documents describe that patients who experience these effects may be advised to use caution when driving or operating machinery.


Q: Are there different brand names for the same drug as Ferricure?

A: Yes, regulatory and authoritative sources indicate that the active substance, Iron Sucrose, is available under different trade names globally. For example, it is known as Venofer in certain regions.


Q: What if a user accidentally takes more Ferricure than usual?

A: Official labeling describes that in the event of a suspected overdose, contact with a poison control center or seeking emergency medical care is indicated. While an overdose may be characterized by high iron levels, the clinical severity can vary.


Q: Can Ferricure affect the results of other medical tests?

A: Yes, the medicine can interfere with certain laboratory tests. Official monitoring guidelines state that the medicine can rapidly increase Transferrin Saturation ( TSAT) values. Therefore, certain serum iron measurements should be postponed for at least 48 hours after administration.

How should Ferricure be stored and disposed of?

Storage Requirements

Ferricure (Iron Sucrose Injection) must be stored at a temperature below 25 C (77 F). It is a mandatory requirement that the solution must not be frozen or refrigerated as this can compromise product integrity. To protect the solution from light, the vials must be kept in the original outer carton until they are ready for use. Like all medications, Ferricure must be kept out of the sight and reach of children.

Handling and Disposal

Before administration, the vial should be visually inspected; only a solution that is clear and free of sediment should be used. Once the product is diluted for infusion, regulatory guidelines require that it be used immediately. Any unused or expired Ferricure must not be disposed of in household waste or wastewater. Disposal must follow local guidelines for pharmaceutical waste and be carried out by a healthcare professional.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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