Therapeutic Classification: antianemics
Pharmacologic Classification: iron supplements
Absorption: Following IV administration, the uptake of iron by the reticuloendothelial system is constant at about 40–60 mg/hr. Following IM doses, 60% is absorbed after 3 days; 90% after 1–3 weeks, the balance is absorbed slowly over mo.
Distribution: Taken up by the reticuloendothelial system.
Metabolism/Excretion: Most sucrose is eliminated in urine. Most of the iron remains stored and used on demand. Small amounts eliminated in urine.
Half-life: 6 hr.
(effects on erythropoiesis)
CV: HF, chest pain, hypertension, hypotension.
Derm: pruritus.
F and E: hypervolemia.
GI: diarrhea, nausea, vomiting , ↑ liver enzymes, abdominal pain.
Local: injection site reactions.
MS: leg cramps, musculoskeletal pain.
Neuro: headache, dizziness, dysgeusia, weakness.
Resp: cough, dyspnea.
Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), sepsis.
- Do not confuse Venofer with Vfend or Vimpat.
- Do not administer iron sucrose concurrently with oral iron, as the absorption of oral iron is reduced. Each mL vial contains 20 mg of elemental iron.
- Solution is brown. Inspect for particulate matter or discoloration. Do not administer solutions that contain particulate matter or are discolored. Solution is stable for 7 days at room temperature or if refrigerated in syringe or 7 days at room temperature diluted in IV bag.
- Pedi: Exercise caution when administering and calculating doses; overdose can be fatal.
IV Administration:
Hemodialysis Dependent Patients:
- Most patients require a minimum cumulative dose of 1000 mg of elemental iron, administered over 10 sequential dialysis sessions, to achieve a favorable hemoglobin or hematocrit response.
- IV Push: May be administered undiluted by slow injection.
- Rate: Inject at a rate of 100 mg over 2–5 min into dialysis line early during the dialysis session (generally within the first hour), not to exceed one vial per injection. Discard any unused portion.
- Intermittent Infusion: May be administered as an infusion of 100 mg diluted in a maximum of 100 mL of 0.9% NaCl.
- Rate: Infuse over at least 15 minutes, per consecutive hemodialysis session.
Non-dialysis Dependent Patients:
- IV Push: May be administered as a slow injection of 200 mg undiluted.
- Rate: Administer over 2–5 min.
- Intermittent Infusion: Dilute 200 mg in 100 mL 0.9% NaCl. Has also been given as 500 mg diluted in 250 mL 0.9% NaCl.
- Rate: Infuse over 15 min. Infuse 500 mg dose over 3.5–4 hr on days 1 and 14. May cause hypotension; monitor closely.
- Additive Incompatibility: Iron sucrose should not be admixed with any other medications or parenteral nutrition solutions.
Peritoneal Dialysis Patients
- Intermittent Infusion:
Diluent: Dilute each dose in a maximum of 250 mL of 0.9% NaCl.
- Rate: Administer doses of 300 mg over 1.5 hr and doses of 400 mg over 2.5 hr.
Pediatric Patients
- IV Push: May be administered undiluted as 0.5 mg/kg, not to exceed 100 mg per dose.
- Rate: Inject over 5 min.
- Intermittent Infusion: Dilute in 0.9% NaCl at a concentration of 1 to 2 mg/mL. Do not dilute to concentrations below 1 mg/mL
- Rate: Infuse over 5–60 min.
