{"id":3599,"date":"2026-09-04T20:01:53","date_gmt":"2026-09-04T20:01:53","guid":{"rendered":"https:\/\/drsoniafawad.com\/?p=3599"},"modified":"2026-09-04T20:01:53","modified_gmt":"2026-09-04T20:01:53","slug":"fda-adds-boxed-warning-to-injectafer-for-hypophosphatemia-risk","status":"publish","type":"post","link":"https:\/\/drsoniafawad.com\/?p=3599","title":{"rendered":"FDA adds boxed warning to Injectafer for hypophosphatemia risk"},"content":{"rendered":"<p><br \/>\n<\/p>\n<div data-component=\"ArticleContent\">\n<div class=\"article__below-title\">\n<div class=\" article__posted-date\">\n<p>September 03, 2026<\/p>\n<p>1 min read<\/p>\n<\/p><\/div>\n<div class=\"mobile-trust-box\">\n<div class=\"row\">\n<div class=\"col-12 col-md-5 d-xl-none\">\n<div class=\"trust-box\">\n<div class=\"trust-box-logo d-none d-md-block\">\n            <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/h5\/feature\/news\/publogos\/neph.svg?la=en&amp;h=30&amp;w=142&amp;hash=48DB28B29782E956859750F4CE62F92F\" class=\"logo-img\" height=\"30\" alt=\"nephrology news and issues logo\" width=\"142\"\/>\n          <\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"col-12 col-md-6 offset-md-1 offset-xl-0 col-xl-12\">\n<div class=\"email-alert-button-wrapper d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>&#13;<br \/>\n        Add topic to email alerts&#13;<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u3ea04a5037504b4bbbb8dd735c6bcb87\">\n<div class=\"email-alert-dialogue\">\n<p>&#13;<br \/>\n          Receive an email when new articles are posted on <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n          Please provide your email address to receive an email when new articles are posted on <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8220;&#13;<br \/>\n              data-action=&#8221;subscribe&#8221;&gt;&#13;<br \/>\n        Subscribe&#13;<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>We were unable to process your request. Please try again later. If you continue to have this issue please contact <a href=\"https:\/\/www.healio.com\/news\/nephrology\/20260903\/mailto:customerservice@slackinc.com\">customerservice@slackinc.com<\/a>.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Back to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<h2>Key takeaways:<\/h2>\n<ul>\n<li>The FDA recommends phosphate monitoring for patients at risk for hypophosphatemia or receiving repeat therapy. <\/li>\n<li>Fewer than 20% of Injectafer administration episodes had serum phosphate laboratory testing.<\/li>\n<\/ul>\n<p>The FDA added a boxed warning detailing the known risk for symptomatic hypophosphatemia associated with ferric carboxymaltose injection, according to an agency press release.<\/p>\n<p>The boxed warning recommends phosphate monitoring for patients at risk for hypophosphatemia and any patients who receive a repeat course of therapy within 3 months of the prior course. Generic ferric carboxymaltose injection products are also expected to update their labels to reflect the added boxed warning, according to the release.<\/p>\n<figure class=\"figure article__og-image\">&#13;\n    <picture>&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.webp?w=476\" media=\"(max-width: 768px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.webp?w=800\" media=\"(max-width: 992px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.webp?w=595\" media=\"(max-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.webp?w=476\" media=\"(min-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.webp?w=476\">&#13;<br \/>\n&#13;<br \/>\n      <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/slack-news\/generic-infographics\/2023\/generic-fda-news.jpg?w=800\" alt=\"Generic FDA News infographic\" class=\"figure-img img-fluid\" width=\"800\"\/>&#13;<br \/>\n    <\/source><\/source><\/source><\/source><\/source><\/picture>&#13;<figcaption class=\"figure-caption\">&#13;<br \/>\n      &#13;<br \/>\n    <\/figcaption>&#13;<br \/>\n  <\/figure>\n<p>Ferric carboxymaltose injection (Injectafer, Daiichi Sankyo\/American Regent), a prescription iron replacement medicine given intravenously, is approved by the FDA for patients aged 1 year and older who cannot tolerate or do not fully respond to oral iron. It is also approved for adults <a href=\"https:\/\/www.healio.com\/news\/nephrology\/20231005\/video-treating-anemia-in-cases-of-severe-ckd\" id=\"rId9\" target=\"_blank\">with chronic kidney disease not on dialysis with iron deficiency<\/a> and <a href=\"https:\/\/www.healio.com\/news\/cardiology\/20230605\/fda-approves-first-iv-iron-replacement-therapy-for-heart-failure\" id=\"rId10\" target=\"_blank\">adults with New York Heart Association class II\/III heart failure<\/a> with iron deficiency to improve exercise capacity.<\/p>\n<p>The decision to add the boxed warning stemmed from an assessment of multiple data sources, including the FDA Adverse Event Reporting System and literature reports. Multiple cases of symptomatic hypophosphatemia tied to single and multiple infusions of ferric carboxymaltose injection were reported despite previous labeling revisions in 2020 and 2023 emphasizing the risk, according to the FDA release.<\/p>\n<p>Additionally, data from the FDA\u2019s Sentinel System show serum phosphate testing occurred in fewer than 20% of ferric carboxymaltose injection administration episodes, according to the release. <\/p>\n<p>Hypophosphatemia may manifest differently based on condition severity and duration, with symptoms including muscle weakness or pain, fatigue, tremors, confusion, seizures and cardiac arrhythmias, according to the release. Serious adverse outcomes associated with ferric carboxymaltose injection include hospitalization, a need for prolonged phosphate replacement therapy, osteomalacia and bone fractures.<\/p>\n<p>Clinicians should inform patients about the risk for hypophosphatemia associated with ferric carboxymaltose injection, according to the release. Clinicians should also continue to monitor serum phosphate levels for at-risk patients and consider permanent discontinuation for persistent hypophosphatemia or severe chronic hypophosphatemia, according to the release.<\/p>\n<div class=\"article__content--footer\">\n<div class=\"publisher-logo\">\n    <span>Published by:<\/span><br \/>\n    <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/h5\/feature\/news\/publogos\/neph.svg?la=en&amp;h=30&amp;w=142&amp;hash=48DB28B29782E956859750F4CE62F92F\" class=\"logo-img\" height=\"30\" alt=\"nephrology news and issues logo\" width=\"142\"\/>\n  <\/div>\n<div class=\"sources-references-disclosures\">\n<h3>Sources\/Disclosures<\/h3>\n<h2> Source: <\/h2>\n<p class=\"citation\">&#13;<br \/>\n  <a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-communications\/fda-adds-boxed-warning-labeling-ferric-carboxymaltose-injection-injectafer-describe-risk-low\" id=\"rId8\" target=\"_blank\">Press Release<\/a>&#13;\n<\/p>\n<div class=\"disclosures\">\n<p>&#13;<br \/>\n        <strong> Disclosures: <\/strong>&#13;<br \/>\n        No products or companies that would require financial disclosure are mentioned in this article.&#13;\n      <\/p>\n<\/p><\/div>\n<\/div>\n<p><!-- Healio AI Widget --><\/p>\n<div class=\"healio-ai-component-inline\" data-no-ads=\"true\" data-module-track-category=\"Healio AI\" data-module-track-action=\"Click\" data-module-track-label=\"Access Healio Ai from component - News_AI Component - In-Content (all devices)\">\n<div class=\"healio-ai-content\">\n    <img decoding=\"async\" src=\"https:\/\/m3.healio.com\/~\/media\/images\/healio-ai\/healio-ai_logo.svg\" alt=\"Healio AI\" class=\"healio-ai-logo\"\/><\/p>\n<p><strong>Ask a clinical question<\/strong> and tap into <strong>Healio AI&#8217;s knowledge<\/strong> base.<\/p>\n<ul>&#13;<\/p>\n<li>PubMed, enrolling\/recruiting trials, guidelines<\/li>\n<p>&#13;<\/p>\n<li>Clinical Guidance, Healio CME, FDA news<\/li>\n<p>&#13;<\/p>\n<li>Healio&#8217;s exclusive daily news coverage of clinical data<\/li>\n<p>&#13;\n    <\/ul>\n<p>    <button class=\"healio-ai-button\" onclick=\"window.location.href=\" https:=\"\">Learn more<\/button>\n  <\/div>\n<\/div>\n<div class=\"email-alert-button-wrapper d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>&#13;<br \/>\n        Add topic to email alerts&#13;<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u3ea04a5037504b4bbbb8dd735c6bcb87\">\n<div class=\"email-alert-dialogue\">\n<p>&#13;<br \/>\n          Receive an email when new articles are posted on <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n          Please provide your email address to receive an email when new articles are posted on <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8220;&#13;<br \/>\n              data-action=&#8221;subscribe&#8221;&gt;&#13;<br \/>\n        Subscribe&#13;<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>We were unable to process your request. Please try again later. If you continue to have this issue please contact <a href=\"https:\/\/www.healio.com\/news\/nephrology\/20260903\/mailto:customerservice@slackinc.com\">customerservice@slackinc.com<\/a>.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Back to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<p><br \/>\n<br \/><a href=\"https:\/\/www.healio.com\/news\/nephrology\/20260903\/fda-adds-boxed-warning-to-injectafer-for-hypophosphatemia-risk\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>September 03, 2026 1 min read &#13; &#13; &#13; Add topic to email alerts&#13; &#13; &#13; Receive an email when new articles are posted on &#13; Please provide your email address to receive an email when new articles are posted on . &#8220;&#13; data-action=&#8221;subscribe&#8221;&gt;&#13; Subscribe&#13; We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: The FDA recommends phosphate monitoring for patients at risk for hypophosphatemia or receiving repeat therapy. Fewer than 20% of Injectafer administration episodes had serum phosphate laboratory testing. The FDA added a boxed warning detailing the known risk for symptomatic hypophosphatemia associated with ferric carboxymaltose injection, according to an agency press release. The boxed warning recommends phosphate monitoring for patients at risk for hypophosphatemia and any patients who receive a repeat course of therapy within 3 months of the prior course. Generic ferric carboxymaltose injection products are also expected to update their labels to reflect the added boxed warning, according to the release. &#13; &#13;&#13;&#13;&#13;&#13;&#13; &#13; &#13; &#13;&#13; &#13; &#13; Ferric carboxymaltose injection (Injectafer, Daiichi Sankyo\/American Regent), a prescription iron replacement medicine given intravenously, is approved by the FDA for patients aged 1 year and older who cannot tolerate or do not fully respond to oral iron. It is also approved for adults with chronic kidney disease not on dialysis with iron deficiency and adults with New York Heart Association class II\/III heart failure with iron deficiency to improve exercise capacity. The decision to add the boxed warning stemmed from an assessment of multiple data sources, including the FDA Adverse Event Reporting System and literature reports. Multiple cases of symptomatic hypophosphatemia tied to single and multiple infusions of ferric carboxymaltose injection were reported despite previous labeling revisions in 2020 and 2023 emphasizing the risk, according to the FDA release. Additionally, data from the FDA\u2019s Sentinel System show serum phosphate testing occurred in fewer than 20% of ferric carboxymaltose injection administration episodes, according to the release. Hypophosphatemia may manifest differently based on condition severity and duration, with symptoms including muscle weakness or pain, fatigue, tremors, confusion, seizures and cardiac arrhythmias, according to the release. Serious adverse outcomes associated with ferric carboxymaltose injection include hospitalization, a need for prolonged phosphate replacement therapy, osteomalacia and bone fractures. Clinicians should inform patients about the risk for hypophosphatemia associated with ferric carboxymaltose injection, according to the release. Clinicians should also continue to monitor serum phosphate levels for at-risk patients and consider permanent discontinuation for persistent hypophosphatemia or severe chronic hypophosphatemia, according to the release. Published by: Sources\/Disclosures Source: &#13; Press Release&#13; &#13; Disclosures: &#13; No products or companies that would require financial disclosure are mentioned in this article.&#13; Ask a clinical question and tap into Healio AI&#8217;s knowledge base. &#13; PubMed, enrolling\/recruiting trials, guidelines &#13; Clinical Guidance, Healio CME, FDA news &#13; Healio&#8217;s exclusive daily news coverage of clinical data &#13; Learn more &#13; &#13; &#13; Add topic to email alerts&#13; &#13; &#13; Receive an email when new articles are posted on &#13; Please provide your email address to receive an email when new articles are posted on . &#8220;&#13; data-action=&#8221;subscribe&#8221;&gt;&#13; Subscribe&#13; We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Source link<\/p>\n","protected":false},"author":1,"featured_media":2941,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3599","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3599","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3599"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3599\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/2941"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3599"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3599"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3599"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}