Adult Dosing
Iron deficiency anemia
- Dialysis patients with CKD
- 100 mg (undiluted) IV over 2-5 mins; Alt: 100 mg (diluted) over at least 15 mins/consecutive hemodialysis session
- Usual total dose: 1000 mg
- Administer drug early during the dialysis session
- Non dialysis patients with CKD
- 200 mg (undiluted) IV over 2-5 mins x5 doses over 2wks; Alt: 500 mg (diluted) over 3.5-4 hrs on day 1 and day 14; however there is limited experience with 500 mg dose regimen
- Usual total dose: 1000 mg
- Peritoneal dialysis patients with CKD
- 300 mg IV over 1.5 hrs x2 doses (14 days apart); wait for 2wks; then 400 mg IV over 2.5 hrs
- Usual total dose: 1000 mg
Notes:- 1 mL= 20 mg elemental Fe
- Administer this drug intravenously either by slow injection or by infusion
- Therapy may be repeated if iron deficiency reoccurs
Pediatric Dosing
Iron deficiency anemia, maintenance treatment
>2 yrs with HDD-CKD for iron maintenance treatment
- 0.5 mg/kg IV q2wk x 12 weeks given undiluted by slow IV and administered over 5 mins or diluted in 25 mL of 0.9% NaCl and administered over 5 to 60 minutes
- Max: 100 mg/dose
>2 yrs with NDD-CKD or PDD-CKD who are on erythropoietin therapy for iron maintenance treatment
- 0.5 mg/kg IV q4wk x 12 weeks given undiluted by slow IV and administered over 5 mins or diluted in 25 mL of 0.9% NaCl and administered over 5 to 60 minutes
- Max: 100 mg/dose
[Outline]
- Serious hypersensitivity reactions (including anaphylactic-type), some life-threatening and fatal have been reported with this drug. Presenting complaints may be shock, clinically significant hypotension, loss of consciousness, and/or collapse. Immediately stop therapy on occurrence of hypersensitivity reactions or signs of intolerance. Monitor for hypersensitivity reactions during and after drug therapy for at least 30 minutes and until clinically stable following completion of the infusion. Administer this drug only when personnel and therapies are immediately available for the management of serious hypersensitivity reactions. Most reactions occur within 30 minutes of completion of infusion with IV preparations
- Hypotension has been reported following administration of this drug which may be related to rate of administration and/or total dose administered. Monitor for signs and symptoms following each administration
- Parenteral iron therapy in excess can lead to excess iron storage thus increasing risk of iatrogenic hemosiderosis. Periodically monitor hematologic and iron parameters (hemoglobin, hematocrit, serum ferritin and transferrin saturation) in patients receiving this drug. Prohibit use in patients with evidence of iron overload. Increase in transferrin saturation level may occur after IV administration of iron sucrose thus do not perform serum iron measurements for at least 48 hours after IV dosing
Cautions: Use cautiously in
Pregnancy Category:B
Breastfeeding: Limited information indicates that breastmilk iron is not increased after intravenous infusion of iron sucrose. Amounts of iron ingested by the infant would be normal and are not expected to cause any adverse effects in breastfed infants; no special precautions are required. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed on 08 August 2011). As per manufacturer information it is not known whether iron sucrose is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised while administering this drug to nursing women.
