Intravenous Iron-deficiency anaemia in chronic renal failure
Adult: Haemodialysis-dependent patient: 100 mg via slow inj over 2-5 min or via infusion over at least 15 min, during each consecutive dialysis session. Usual cumulative dose: 1,000 mg. Peritoneal dialysis-dependent patient: 300 mg via infusion over 1.5 hr for the 1st 2 doses, 14 days apart, followed by 400 mg via infusion over 2.5 hr 14 days later. Nondialysis-dependent patient: 200 mg via slow inj over 2-5 min or via infusion over 15 min, given in 5 different occasions over a 14-day period. Treatment may be repeated if necessary. Child: ≥2 yr As maintenance therapy: Haemodialysis-dependent patient: 0.5 mg/kg (Max: 100 mg) every 2 wk for 12 wk. Nondialysis-dependent or peritoneal dialysis-dependent patients who are receiving erythropoietin therapy: 0.5 mg/kg (Max: 100 mg) every 4 wk for 12 wk. Doses may be given via slow inj over 5 min or via infusion over 5-60 min. Treatment may be repeated if necessary.
Intravenous Iron-deficiency anaemia
Adult: In cases wherein oral Fe therapy is ineffective or impractical: Total cumulative dose is calculated individually based on body wt and Hb level. Usual dose: 5-10 mL (100-200 mg elemental Fe) 1-3 times wkly via slow inj at a rate of 20 mg/min or via infusion at a rate of ≤100 mg/15 min.
Reconstitution
Soln for infusion: Adult: Dilute in a max of 100 mL (doses ≤200 mg) or 250 mL (doses >200 mg) of NaCl 0.9%. Childn: Dilute in 25 mL of NaCl 0.9%.
Contraindications
Hypersensitivity to Fe sucrose or other parenteral Fe products. Anaemia not caused by Fe deficiency, evidence of Fe overload or hereditary disturbances in utilisation of Fe. 1st trimester of pregnancy.
Special Precautions
Patient w/ immune or inflammatory conditions, acute or chronic infections, history of asthma, eczema, or other atopic allergies. Hepatic impairment. Pregnancy (2nd and 3rd trimester) and lactation.
Adverse Reactions
Significant: Hypotension. Nervous: Headache, dizziness, loss of consciousness, collapse, seizures. CV: Chest pain, peripheral oedema. GI: Diarrhoea, nausea, vomiting. Resp: Dyspnoea. Musculoskeletal: Pain in extremity, arthralgia, back pain, muscle cramps. Dermatologic: Pruritus. Others: Inj site reactions. Potentially Fatal: Anaphylactic reactions.
This drug may cause dizziness, confusion, or lightheadedness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor Hb, haematocrit, serum ferritin, and transferrin saturation periodically. Monitor closely for signs and symptoms of hypersensitivity during and after admin.
Overdosage
Symptoms: Fe overload, manifested as haemosiderosis. Management: Supportive treatment. Fe chelating agent may be given as required.
Drug Interactions
May reduce the absorption of oral Fe preparations.
Action
Description: Mechanism of Action: Iron sucrose is an aqueous complex of polynuclear Fe(III)-hydroxide and sucrose which is broken down into iron and sucrose by the reticuloendothelial system. This results in increased serum iron concentrations and is incorporated into haemoglobin. Pharmacokinetics: Absorption: Time to peak plasma concentration: 10 min. Distribution: Distributed mainly in the blood and to some extent in extravascular fluid. Metabolism: Dissociated into Fe and sucrose by macrophages of the reticuloendothelial system in the liver, spleen, and bone marrow. Excretion: Via urine (approx 5%). Terminal elimination half-life: Approx 6 hr.
Chemical Structure
Iron sucrose Source: National Center for Biotechnology Information. PubChem Database. Iron sucrose, CID=91663255, https://pubchem.ncbi.nlm.nih.gov/compound/Iron-sucrose (accessed on Jan. 21, 2020)
Anon. Iron Sucrose. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/02/2017.Buckingham R (ed). Iron Sucrose. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/02/2017.Joint Formulary Committee. Iron Sucrose. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/02/2017.McEvoy GK, Snow EK, Miller J et al (eds). Iron Sucrose. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 22/02/2017.Pharmacy Retailing NZ Limited. Venofer data sheet 4 April 2016. Medsafe. http://www.medsafe.govt.nz/. Accessed 22/02/2017.Venofer Injection, Solution (American Regent, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 22/02/2017.
Sign Out
