Pronunciation: I-ern SUE-krose
Class: Iron product
- Injection 20 mg/mL
Replenishes Hgb and depleted iron stores.
The apparent Vd is 10 L and the Vd ss is 7.9 L.
Dissociated into iron and sucrose by the reticuloendothelial system.
Sucrose component mainly excreted in the urine. The t ½ is 6 h. The Cl is 1.2 L/h.
Indications and Usage
Treatment of iron deficiency anemia in non-dialysis dependent-chronic kidney disease (CKD) patients either receiving or not receiving an erythropoietin, hemodialysis dependent-CKD patients receiving an erythropoietin, or peritoneal dialysis-CKD patients receiving an erythropoietin.
Iron overload; anemia not caused by iron deficiency; hypersensitivity to any component of product.
Dosage and AdministrationHemodialysis Dependent-CKD Patients
IV Either undiluted as a 100 mg slow injection over 2 to 5 min or as an infusion of 100 mg, diluted in a maximum of 100 mL of sodium chloride 0.9% over a period of at least 15 min/consecutive hemodialysis session for a total cumulative 1,000 mg dose.Non-dialysis Dependent-CKD Patients
IV Total cumulative dose of 1,000 mg over a 14-day period as a 200 mg slow injection undiluted over 2 to 5 min on 5 different occasions within the 14-day period.Peritoneal Dialysis Dependent-CKD Patients
IV Total cumulative dose of 1,000 mg in 3 divided doses, given by slow infusion, within a 28-day period: 2 infusions of 300 mg over 1.5 h 14 days apart followed by one 400 mg infusion over 2.5 h 14 days later.
- Discontinue oral iron preparations before administering parenteral iron products. Coadministration of parenteral iron preparations may reduce absorption of oral iron.
- The dosage is expressed in terms of elemental iron.
- For IV administration only. Not for intradermal, subcutaneous, IM, or intra-arterial administration.
- Medication is administered 1 to 3 times/wk. Do not administer more than 3 times/wk.
- For IV infusion in adults, dilute contents of 1 vial in 100 mL sodium chloride 0.9% injection immediately prior to infusion and infuse over 15 min.
- Discard any unused diluted solution. Do not save unused solution for future use.
- Do not administer if particulate matter or discoloration noted.
Store vials at controlled room temperature (59° to 86°F). Protect from freezing. Use immediately after dilution in saline.
Drug InteractionsOral iron
Absorption of oral iron may be reduced.
Do not mix with other medication or add to parenteral nutrition solutions for IV infusion.
Laboratory Test Interactions
None well documented.
Hypertension (8%); hypotension (3%); cardiac murmur (2%); congestive cardiac failure (postmarketing).
Headache (13%); dizziness (7%); fatigue (6%); asthenia (3%); hypoesthesia (2%).
Pruritus (9%); rash (2%).
Pharyngitis (7%); conjunctivitis, nasopharyngitis (3%); allergic rhinitis, ear pain, nasal congestion (2%).
Nausea (15%); constipation (13%); diarrhea (10%); vomiting (9%); dysgeusia (8%); abdominal pain (7%).
Positive fecal occult blood (4%).
Edema (11%); catheter site infection (9%); injection site burning (4%); extravasation, pain (2%).
Hypoglycemia (4%); fluid overload, gout, hyperglycemia (3%).
Muscle cramp (30%); pain in extremity (7%); arthralgia, arthritis, back pain, myalgia (4%).
Dyspnea, sinusitis (4%); cough, upper respiratory tract infection (3%).
Peritoneal infection (11%); graft complication (10%); edema (7%); chest pain (6%); feeling abnormal, pyrexia (3%); peripheral edema (at least 2%); anaphylactoid reactions including life-threatening reactions (eg, anaphylactic shock, bronchospasm with dyspnea, convulsion, loss of consciousness or collapse), sepsis (postmarketing).
Ensure Hgb, Hct, serum ferritin, and transferrin saturation are determined before starting therapy and periodically during treatment. Note that serum iron levels may be reliably obtained 48 h after IV dosing.BP
Monitor BP during infusion. If hypotension occurs, slow infusion rate. If hypotension continues, discontinue infusion and be prepared to treat appropriately.
Category B .
Safety and efficacy not established.
Select dose with caution, reflecting greater frequency of decreased hepatic, renal, or cardiac function and comorbidity.
Potentially fatal hypersensitivity reactions, including anaphylactic shock, may occur.
Hypotension related to the rate of administration and total dose administered may occur.
Exercise caution and withhold iron administration if there is evidence of tissue iron overload.
Abdominal and muscle pain, CV collapse, dizziness, dyspnea, edema, headache, hypotension, joint aches, nausea, paresthesia, vomiting.
- Advise patient that medication will be prepared and administered by health care provider during dialysis sessions and that medication will not be administered at home.
- Instruct patient to immediately inform health care provider if any of the following occur during or shortly after the administration of drug: anxiety; chest, back, flank, or groin pain; itching; lightheadedness; rapid heart beat; rash; shortness of breath or difficulty breathing; sweating; swelling of the throat; weakness.
- Caution patient not to take oral iron supplements while receiving IV iron.
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