A 29-year-old woman at 28 weeks has iron deficiency anaemia with haemoglobin 7.4 g/dL. She had significant nausea and vomiting with oral iron and her haemoglobin rose by only 0.3 g/dL after four weeks of therapy. Intravenous ferric carboxymaltose is planned. What is the maximum single-dose limit of ferric carboxymaltose?
- A 500 mg
- B 750 mg
- C 1000 mg ✓
- D 1500 mg
Correct answer: C. 1000 mg
Explanation
Ferric carboxymaltose allows rapid repletion because up to 1000 mg (or 15 mg/kg, whichever is lower) can be given as a single intravenous infusion, usually permitting total dose correction in one or two sittings. This is its principal advantage over iron sucrose, which is limited to 200 mg per session and needs multiple visits. Doses above 1000 mg in a single sitting are not recommended because of the risk of hypophosphataemia and flushing reactions.
Reference: Williams Obstetrics, 26th ed.
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