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Iron Sucrose Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Iron Deficiency Anemia

Hemodialysis Dependent Chronic Kidney Disease (HDD-CKD):
5 mL (100 mg elemental iron) undiluted slow IV over 2 to 5 minutes. Alternatively, 5 mL (100 mg elemental iron) diluted in a maximum of 100 mL of 0.9% sodium chloride IV over at least 15 minutes. Repeat at consecutive hemodialysis sessions for a total cumulative dose of 1000 mg.

Non- Dialysis Dependent Chronic Kidney Disease (NDD-CKD):
10 mL (200 mg elemental iron), undiluted, IV over 2 to 5 minutes administered on 5 different occasions within a 14- day period to achieve a total cumulative dose of 1000 mg within the 14- day period.

Alternatively, 25 mL (500 mg elemental iron), diluted in a maximum of 250 mL sodium chloride 0.9%, IV over 210 to 240 minutes administered on day 1 and day 14 to give a cumulative dose of 1000 mg within a 14- day period. However, there is limited experience with this dosage regimen. A clinical trial (n=30) reported hypotension in 2 patients following administration of this dosage regimen.

Peritoneal Dialysis Dependent Chronic Kidney Disease (PDD-CKD):
Two infusions of 15 mL (300 mg elemental iron) each diluted in a maximum of 250 mL of 0.9% sodium chloride administered IV over 90 minutes 14 days apart, followed by one infusion of 20 mL (400 mg elemental iron) diluted in a maximum of 250 mL of 0.9% sodium chloride administered over 150 minutes 14 days after second dose for a total cumulative dose of 1000 mg infused within a 28 day period.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Data not available

Precautions

Hypotension has been reported frequently in patients receiving intravenous iron. Hypotension following administration of iron sucrose may be related to rate of administration and total dose administered.

Serious hypersensitivity reactions have been reported rarely in patients receiving iron sucrose therapy. Clinical studies report several mild or moderate hypersensitivity reactions, but no serious reactions. Between 1992 and February 2005, a total of 104 anaphylactoid reactions including serious or life-threatening reactions have been reported in postmarketing spontaneous reports worldwide based on estimated use in more than 3.8 million patients.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

No adjustment recommended

Other Comments

Iron sucrose administration requires monitoring of hematologic and hematinic parameters such as hemoglobin, hematocrit, serum ferritin and transferrin saturation. Iron sucrose should be withheld in patients with evidence of iron overload. Excess tissue iron can be hazardous to patients. Serum iron values may be reliably obtained 48 hours after IV administration.

Iron sucrose may be a safer alternative in patients who experience a hypersensitivity reaction to iron dextran.

An alternative, high-dose intravenous dosage regimen has been suggested for iron-deficient, anemic chronic kidney disease patients (500 mg iron surcrose in 200 mL of normal saline administered IV over 3 hours on 2 consecutive days). This dosage regimen appears to be well-tolerated and effective for replenishing iron stores and stimulating hematopoiesis in this patient population.

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