Document resource
Background and Importance There is a need to evaluate the adequacy of ferric carboxymaltose prescriptions in relation to the actual analytical requirements of each patient. According to the technical data sheet (TDS), ferric carboxymaltose (Fe) is indicated for the treatment of iron deficiency when rapid administration is necessary, or when the oral route cannot be used or has proven ineffective.Aim and Objectives To evaluate ferric carboxymaltose (FC) prescriptions made by different clinical services in a tertiary care hospital, according to compliance with the pharmacotherapeutic protocol approved by the hospital’s Pharmacy and Therapeutics Committee.Material and Methods A retrospective, observational study conducted between January and December 2024. All ferric carboxymaltose prescriptions requested through a dynamic form in the FarmaTools software were evaluated daily to validate their appropriateness according to the established protocol. Inclusion criteria: anaemic patients scheduled for major potentially bleeding surgery with Hb<13 g/dl, previous oral iron treatment and/or need for a rapid response, along with an iron saturation (IST) <20%. Variables collected: sex, requesting department, prior oral iron treatment, Hb levels before and after administration, IST, request status (approved or rejected), and reason for rejection.Results A total of 476 requests were reviewed, of which 88.65% (422) were approved. Distribution by sex: 57.35% women and 42.64% men. Distribution by departments: Emergency (18.27%), Gastroenterology (16.80%), Traumatology (16.59%), Coloproctology and Digestive Surgery (15.75%), Cardiology (13.65%), Internal Medicine (10.71%), Hepatobiliary Surgery (9.24%), and 7.35% other departments. 18.48% had previously received oral iron and the mean Hb before administration was 8.61 g/dl. Post-administration Hb values showed a mean increase of 3.31 g/dl. The mean IST in approved requests was 29.68%. A total of 54 requests were rejected due to IST >20% (81.20%) or absence of prior oral iron treatment (18.80%).Conclusion and Relevance Parenteral administration of FC provides better tolerability compared to oral administration, although it is not free from adverse effects. This study demonstrates that the pharmaceutical intervention prevented the inappropriate use of FC in patients eligible for its administration who presented analytical values above those established in the protocol and/or lacked prior oral iron treatment. Pharmaceutical intervention was key to ensuring that patients receive medication appropriate to their clinical and analytical needs.Conflict of Interest No conflict of interest