1. iron sucrose decreases levels of ciprofloxacin by inhibition of GI absorption. The dosage of iron sucrose is expressed in mg of elemental iron. Separate by at least 4 hours. Use Caution/Monitor. STORAGE: Consult the product instructions and your pharmacist for storage details. Monitor for signs and symptoms of hypotension following each administration of Venofer. Separate dosing of tetracyclines from these products. iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. The primary endpoint was the proportion of patients with . Venofer treatment may be repeated if necessary. esomeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Methods: We reviewed the experience of our department between January, 2011 and February, 2014 with the use of intravenous iron sucrose in children 14 years of age who failed in oral iron therapy for iron deficiency anemia (IDA). For all products, slow initial infusion is prudent; the patient is observed closely for infusion reactions. Administer Injectafer intravenously, either as an undiluted slow intravenous push or by infusion. Applies only to oral form of both agents. 3) Auerbach M, Witt D, Toler W, Fierstein M, Lerner RG, Ballard H. (1988) Clinical use of the total dose intravenous infusion of iron dextran. 1982;13(4):309-21. The two formulas used are presented below: Iron deficit in mg = Weight in kg x (14 - Hb in g/dL) x 2.145 Volume of product required in mL = Iron deficit in mg / C in mg/mL Where C is the concentration of the iron product: 50 mg/mL for Iron dextran; 20 mg/mL for Iron sucrose; 5 mg/mL for Ferric gluconate. Do not dilute to concentrations below 1 mg/mL [see How Supplied/Storage and Handling (16.2).] Hanson DB, Hendeles L. Guide to total dose intravenous iron dextran therapy. Although the original formula requires the weight in kilograms, values input in lbs are transformed. Monitor Closely (1)pantoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. A target haemoglobin value is also input so iron deficit can be determined according to a specified individual target. Administer while the patient is in a reclined or semi-reclined position. A patients lean body weight (or actual body weight if less than lean body weight) should be utilized when determining dosage. FOR PATIENTS WEIGHING 50 kg OR MORE: Administer 1000 mg of Monoferric by intravenous infusion 20 minutes as a single dose 1. Minor (1)iron sucrose, captopril. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product that meets the needs of the patient. I. Modify Therapy/Monitor Closely. Patients may present with shock, clinically significant hypotension, loss of consciousness and/or collapse. Applies only to oral form of both agents. Copyright 1993-2021 Use Caution/Monitor. gymnema decreases levels of iron sucrose by inhibition of GI absorption. Give each dose as 750 mg for a total cumulative dose not to exceed 1500 mg of iron per course. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration. Injection: 50 mg/2.5 mL, 100 mg/5 mL, or 200 mg/10 mL (20 mg/mL) in single-dose vials. Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin, Do not mix with other medications or add to parenteral nutrition solutions for IV infusion, Do not dilute to concentrations below 1 mg/mL, Add dose to 0.9% NaCl infusion bags (PVC or non-PVC); final concentrations range is 1-2 mg of elemental iron/mL, Visually inspect for particulate matter and discoloration prior to infusion, Stable for 7 days at controlled room temperature (25C). * Adapted from the KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight. Ensure the Intravenous Iron Checklist (see trust guideline) has been completed. Minor/Significance Unknown. Intravenous therapy is preferred for urgent intervention and when oral iron cannot be absorbed or the patient suffers from chronic renal impairment. 2010niferex-hytinic-polysaccharide-iron-342160Drugs, You are being redirected to
When iron sucrose was administered at deliberate overdoses to rabbit dams (up to 215 mg/kg/day) marked fetal/placental iron overload was noted. In: Koda-Kimble & Young's Applied Therapeutics: The Clinical Use of Drugs. Ferrlecit may also be administered undiluted as a slow intravenous injection (at a rate of up to 12.5 mg/min) per dialysis session. Applies only to oral form of both agents. The recommended dosage of iron sucrose for repletion of iron deficiency in patients undergoing hemodialysis is 5ml of iron sucrose (100mg of elemental iron) delivered intravenously during the dialysis session. Applies only to oral form of both agents. Minor/Significance Unknown. Use Caution/Monitor. Anemia caused by the depletion of iron is called iron deficiency anemia. Venofer treatment may be repeated if necessary. Assure stable intravenous access to avoid extravasation. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Symptoms associated with Venofer total dosage or infusing too rapidly included hypotension, dyspnea, headache, vomiting, nausea, dizziness, joint aches, paresthesia, abdominal and muscle pain, edema and cardiovascular collapse. Philadelphia, PA: Lippincott Williams & Wilkins;2013;303-307. Avoid or Use Alternate Drug. Dose administration to an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. SIDE EFFECTS: Muscle cramps, nausea, vomiting, strange taste in the mouth, diarrhea, constipation, headache, cough, back pain, joint pain, dizziness, or swelling of the arms/legs may occur. Applies only to oral form of both agents. Applies only to oral form of both agents. 1988 May;111(5):566-70. Where C= concentration of elemental iron (mg/ml) in the product being used: Data from Ferrlecit postmarketing spontaneous reports indicate that individual doses exceeding 125 mg may be associated with a higher incidence and/or severity of adverse events, Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD), Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD), WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS, Iron Deficiency and Anemia- signs and therapeutic options. Use Caution/Monitor. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. Evaluate the hematologic response (hemoglobin, ferritin, iron and transferrin saturation) at least one month following the second Feraheme infusion. Anemia; 2015: 763576. sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron sucrose by inhibition of GI absorption. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Venofer is injected. iron sucrose will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Serious - Use Alternative (1)iron sucrose decreases levels of minocycline by inhibition of GI absorption. Use Caution/Monitor. Venofer (Iron Sucrose Injection) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. 1000 mg. 20 MINUTES. It is usually given slowly over 2 to 5 minutes or as directed by your doctor. calcium acetate decreases levels of iron sucrose by inhibition of GI absorption. nizatidine will decrease the level or effect of iron sucrose by increasing gastric pH. Avoid or Use Alternate Drug. All you have to do is use the following formula: Liquid\ dose = Dose / Medicine\ concentration Liquid dose = Dose/M edicine concentration. Monitor Closely (1)iron sucrose will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Iron Product. The dosage of Venofer is expressed in mg of elemental iron. Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of iron sucrose by inhibition of GI absorption. Use Caution/Monitor. Use Caution/Monitor. The dosing for iron replacement treatment in pediatric patients with Peritoneal or Hemodialysis-Dependent - CKD or Non-Dialysis Dependent CKD have not been established. Separate dosing of tetracyclines from these products. Applies only to oral form of both agents. Use Caution/Monitor. Interaction only with oral iron administration. Iron metabolism needs to be balanced and bleeding, the major cause of iron deficiency (for instance in menstruation in females and chronic occult gastrointestinal bleeding) needs to be addressed. Applies only to oral form of both agents. Venofer is given as an infusion into a vein. Applies only to oral form of both agents. Recommended Treatment Regimen Using IV Iron Sucrose for Initial Repletion in Children With Iron Deficiency Anemia. Applies only to oral form of both agents. David McAuley, Pharm.D. Taking the case of a patient weighing 75 kg (165.3 lbs) with a target hemoglobin value of 13 g/dL (130 g/L or 8.07 mmol/L), an actual hemoglobin of 9.5 g/dL (95 g/L or 5.9 mmol/L) and iron stores of 500 mg, the iron deficit is: Iron deficit = 75 x (13 9.5) x 2.4 + 500 = 1,130 mg. Use Caution/Monitor. Access your plan list on any device mobile or desktop. Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. Either increases effects of the other by pharmacodynamic synergism. All adult and pediatric patients receiving Venofer require periodic monitoring of hematologic and iron parameters (hemoglobin, hematocrit, serum ferritin and transferrin saturation). If these effects continue or worsen, tell your doctor.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Calculates iron deficit for dosing iron. Monitor Closely (1)iron sucrose decreases levels of liothyronine by inhibition of GI absorption. Minor/Significance Unknown. The dosing of Monofer was performed according to the Simplified Table as described in section 4.2 above and dosing of iron sucrose was calculated according to Ganzoni and administered as 200 mg infusions. Applies only to oral form of both agents. Use Caution/Monitor. Consult your doctor for more details.Remember that it is best to get your vitamins and minerals from food whenever possible. Intravenous iron-dextran: therapeutic and experimental possibilities [in German] Schweiz Med Wochenschr. To provide clinicians with evidence-based guidance for iron therapy dosing in patients with iron deficiency anemia (IDA), we conducted a study examining the benefits of a higher cumulative dose of intravenous (IV) iron than what is typically administered. Monitor Closely (1)iron sucrose decreases levels of deferiprone by enhancing GI absorption. Venofer has not been studied in patients younger than 2 years old. There is limited experience with administration of an infusion of 500 mg of Venofer, diluted in a maximum of 250 mL of 0.9% NaCl, over a period of 3.5 to 4 hours on Day 1 and Day 14. Share cases and questions with Physicians on Medscape consult. iron sucrose decreases levels of minocycline by inhibition of GI absorption. iron sucrose decreases levels of gemifloxacin by inhibition of GI absorption. (See also Notes section. ------------------------------------------------------------------------- Ferric Carboxymaltose [ Injectafer ] Elemental iron: Injectafer contains 50 mg of elemental iron - 750 mg/15 mL [package insert] Indications: Injectafer is indicated for the treatment of iron deficiency anemia in adult patients: who have intolerance to oral iron or have had unsatisfactory response to oral iron; who have non-dialysis dependent chronic kidney disease. Most reactions associated with intravenous iron preparations occur within 30 minutes of the completion of the infusion. Your doctor will do laboratory tests to monitor your response. 1974 Jun;31(6):592-5. Venofer must only be administered intravenously either by slow injection or by infusion. ANNA J. Auerbach M, Witt D, Toler W, Fierstein M, Lerner RG, Ballard H. Clinical use of the total dose intravenous infusion of iron dextran. 0.5 mg/kg/min (0.005 mL/kg/min) Maximum infusion rate (if tolerated) Increase to 8 mg/kg/min (0.08 mL/kg/min) Monitor the patient's vital signs throughout the infusion. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. It is usually given slowly over 2 to 5 minutes or as directed by your doctor. Use Caution/Monitor. Monitor Closely (1)sodium citrate/citric acid will decrease the level or effect of iron sucrose by increasing gastric pH. Venofer (iron sucrose injection, USP) is a brown, sterile, aqueous, complex of polynuclear iron (III)- . ibuprofen/famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. 200-800 mg/kg (2-8 mL/kg) every 3-4 weeks. Initial infusion rate. Applies only to oral form of both agents. Pregnancy: Risk Summary-Clinical Considerations. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvdmVub2Zlci1pcm9uLXN1Y3Jvc2UtMzQyMTYy, View explanations for tiers and In key trials, ferric carboxymaltose increased Hb levels and replenished iron stores as effectively as IV iron sucrose . Applies only to oral form of both agents. Next Steps Evidence Creator Insights Dr. Andreas M. Ganzoni About the Creator The prevention and treatment of iron deficiency is a major public health goal, especially in women, children, and individuals in low-income countries. Estimates the iron deficit in preparation for iron replacement based on patient weight and haemoglobin. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations. calcium carbonate decreases levels of iron sucrose by inhibition of GI absorption. Applies only to oral form of both agents. Parenteral iron dextran therapy. UpToDate. Applies only to oral form of both agents. Do not administer Venofer to patients with iron overload. 2) Koch TA, Myers J, Goodnough LT. (2015) Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Venofer® (iron sucrose) injection, USP is indicated for the treatment of iron deficiency anemia (IDA) in patients with chronic kidney disease (CKD). Avoid or Use Alternate Drug. There are physiological variation in iron reserves such as the decrease during menstruation period. Deferasirox chelates iron. 300-500 mg Iron Sucrose in NS 250 mL administered over three (3) hours; may repeat as needed in 3-7 days to reach 1 gm. Use Caution/Monitor. Serious - Use Alternative (1)iron sucrose decreases levels of fleroxacin by inhibition of GI absorption. These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. iron sucrose increases levels of calcium citrate by enhancing GI absorption. Minor (1)gymnema decreases levels of iron sucrose by inhibition of GI absorption. Minor/Significance Unknown. Your dosage and length of treatment are based on your medical condition, age, and response to treatment. iron sucrose decreases levels of ofloxacin by inhibition of GI absorption. Separate dosing of tetracyclines from these products. Monitor Closely (1)lansoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Use Caution/Monitor. This drug is available at a higher level co-pay. Minor/Significance Unknown. Applies only to oral form of both agents. In a randomized, open-label, dose-ranging trial for iron maintenance treatment with Venofer in pediatric patients with CKD on stable erythropoietin therapy [see Clinical Studies ( 14.7)], at least one adverse reaction was experienced by 57% (27/47) of the patients receiving Venofer 0.5 mg/kg, 53% (25/47) of the patients receiving Venofer 1 mg . iron sucrose decreases levels of manganese by inhibition of GI absorption. FERAHEME Dosing & Administration - Feraheme FERAHEME has flexible dosing for your patients FERAHEME flexible scheduling gives your patients the freedom to receive the iron they need as early as 3 days apart 1 FLEXIBLE DILUTION OPTIONS 1 Dilute full contents of vial (17 mL) in 50 mL to 200 mL of: 0.9% NaCl, or 5% dextrose STORAGE 1 It should be recognized that iron storage may lag behind the appearance of normal blood morphology. Iron deficiency anemia calculator (diagnosis), Iron deficiency anemia vs. Iron sucrose can also be mixed in a saline solution and given through an IV over a longer time.Your dosage and length of treatment are based on your medical condition, age, and response to treatment. IDA symptoms are often nonspecific and include tiredness, weakness, shortness of breath. Dosing Considerations (8-10) Maximum single dose of iron sucrose in all other patients is 300 mg every week. Use Caution/Monitor. Minor/Significance Unknown. DOSAGE AND ADMINISTRATION: Oral iron should be discontinued prior to administration of INFeD. Adults and Children over 15 kg (33 lbs): Dose (mL) = 0.0442 (Desired Hb - Observed Hb) x LBW + (0.26 x LBW), Desired Hb = the target Hb in g/dl. It is unlikely . 2010;18(3). Hemoglobin there are two fields for hemoglobin input, one for the target and another for actual value. Fatal reactions have followed the test dose of iron dextran injection. Applies only to oral form of both agents. Either decreases levels of the other by inhibition of GI absorption. Elemental iron product this is a choice between three iron supplement products: Iron dextran 50 mg/mL, Iron sucrose 20 mg/mL and Ferric gluconate 12.5 mg/mL. Applies only to oral form of both agents. Individual doses of 2 mL or less may be given on a daily basis until the calculated total amount required has been reached. Most This site complies with the HONcode standard for trust- worthy health information: verify here. This topic . Applies only to oral form of both agents. Although anaphylactic reactions known to occur following INFeD administration are usually evident within a few minutes, or sooner, it is recommended that a period of an hour or longer elapse before the remainder of the initial therapeutic dose is given. Use Caution/Monitor. A healthcare provider will give you this injection. A patients lean body weight (or actual body weight if less than lean body weight) should be utilized when determining dosage. Hollands J, Foote E, Rodriguez A. Applies only to oral form of both agents. The total amount of INFeD in mL required to treat the anemia and replenish iron stores may be approximated as follows: Adults and Children over 15 kg (33 lbs): See Dosage Table. Before using, check this product visually for particles or discoloration. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. The incidence of adverse events with the 400- and 500-mg doses administered as a 2-hour . Applies only to oral form of both agents. In case a pediatric patient with a weight below 35 kg is assessed, iron stores are calculated as 15 mg iron for each kg. The elemental iron product used is Iron sucrose 20 mg/mL. In the text below the tool there is more information on how the iron deficit is calculated. The therapeutic management of IDA focuses on the replenishment of the iron stores through methods that have been mentioned above. For iron maintenance treatment: Administer Venofer at a dose of 0.5 mg/kg, not to exceed 100 mg per dose, every four weeks for 12 weeks given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at a concentration of 1 to 2 mg/mL and administered over 5 to 60 minutes. The factor 2.4 comes about from the calculation that the total iron content of hemoglobin is 0.34%, the blood volume accounts for 7% . Methods. VENOFER at IV doses up to 15 mg iron/kg/dose [about 10 times the maximum recommended human dose for a 70 kg person] given three times a week was found to have no effect on fertility . Use Caution/Monitor. Each mL contains 20 mg of elemental . Applies only to oral form of both agents. Use Caution/Monitor. These can be input in g/dL, g/L or mmol/L. Symptoms associated with Venofer total dosage or infusing too rapidly included hypotension, dyspnea, headache, vomiting, nausea, dizziness, joint aches, paresthesia, abdominal and muscle pain, edema and cardiovascular collapse. The following table present normal hemoglobin ranges: There is another equation for iron deficit that can be used to calculate replenishment needs, that of Ganzoni, which takes into account iron stores as well and that can be found in the iron deficit calculator. Avoid or Use Alternate Drug. iron sucrose decreases levels of deferiprone by enhancing GI absorption. Use Caution/Monitor. This health tool computes the iron deficit based on patient parameters and the Ganzoni formula. commonly, these are generic drugs. The dosage of Venofer is expressed in mg of elemental iron. Minor/Significance Unknown. The iron deficit calculator is useful as one of the determinations performed before iron replenishment therapy is initiated. Intravenous iron sucrose: establishing a safe dose. The recommendation is that most adults need a cumulative dose of elemental iron of at least 1 g. Iron replenishment can be done intravenously, either as total dose (example: iron-dextran or iron carboxymaltose) or as split dose (example: iron sucrose). Minor/Significance Unknown. LBW = Lean body weight in kg. Iron deficiency anemia is the type of anemia caused by iron depletion. Alldredge BK, Corelli RL, Ernst ME, Guglielmo BJ, eds. Both the 200- and 300-mg doses of IV iron sucrose administered over 2 hours appear to be safe. Calculation of total iron deficit for initial repletion: [29] Total cumulative dose (mg) = [Target Hb Actual Hb] weight (kg) 2.4 + [15 weight (kg)] *Hb in g/dl: 2. Applies only to oral form of both agents. Oral and parenteral products - see background option for oral products. This parenteral iron replacement for iron deficiency anemia calculator determines the parenteral dose of iron supplement needed to replenish iron stores and hemoglobin levels. Administer Venofer 200 mg undiluted as a slow intravenous injection over 2 to 5 minutes or as an infusion of 200 mg in a maximum of 100 mL of 0.9% NaCl over a period of 15 minutes. Do not double the dose to catch up. Minor/Significance Unknown. Written by ASHP. Avoid or Use Alternate Drug. For patients weighing less than 50 kg (110 lb): Give Injectafer in two doses separated by at least 7 days. Modify Therapy/Monitor Closely. . We'll do this entirely for free, as long as the calculator has applications for women's health. Prescribing and dispensing information For iron sucrose A complex of ferric hydroxide with sucrose containing 2% (20 mg/mL) of iron. Use Caution/Monitor. Intravenous iron-dextran: therapeutic and experimental possibilities. Separate by at least 4 hours. Minor (2)calcium acetate decreases levels of iron sucrose by inhibition of GI absorption. Use alternatives if available. The dosing for iron replacement treatment in pediatric patients with NDD-CKD or PDD-CKD has not been established. Use Caution/Monitor. 2 Protocol for Intravenous iron sucrose - Venofer 2.1 Dosage The total cumulative dose of Venofer should be calculated using the table below. You will have to pay for your IV iron. For liquid medications, also enter the value of the Medicine Concentration and choose . DICP. ADMINISTER THE TEST DOSE AT A GRADUAL RATE OVER AT LEAST 30 SECONDS. 0.5 mg/kg (not to exceed 100 mg/dose) diluted to a concentration of 1 to 2 mg/mL in 0.9% sodium chloride IV over 5 to 60 minutes Administer every 4 weeks for 12 weeks Do not dilute to concentrations below 1 mg/mL Comments: Treatment may be repeated if necessary. Total dose iron infusion: safety and efficacy in predialysis patients. Use Caution/Monitor. If we don't have the calculator you need then tell us the details and we'll make it for you. Use alternatives if available. For patients receiving hemodialysis, administer Feraheme once the blood pressure is stable and the patient has completed at least one hour of hemodialysis.
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