Venofer must only be administered intravenously either by slow injection or by infusion. Learn how to store and discard medical supplies safely. Applies only to oral form of both agents. Applies only to oral form of both agents. Crown Rump Length and Nuchal Translucency. Use Caution/Monitor. There are four fields that need to be completed: Weight body weight is used to establish iron deficit and is also taken into account when estimating the iron stores. Ferrlecit may be diluted in 100 mL of 0.9% sodium chloride administered by intravenous infusion over 1 hour per dialysis session. Applies only to oral form of both agents. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. omeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Serious - Use Alternative (1)iron sucrose decreases levels of gemifloxacin by inhibition of GI absorption. Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD): 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 x 15 minutes. Med J Aust. PDF Injectafer (ferric carboxymaltose injection) - Food and Drug Administration 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. Monitor Closely (1)iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. STORAGE: Consult the product instructions and your pharmacist for storage details. Applies only to oral form of both agents. Applies only to oral form of both agents. calcium chloride decreases levels of iron sucrose by inhibition of GI absorption. Intravenous iron sucrose: establishing a safe dose. Fulminant symptoms include confusion, sensation of passing out, paleness. esomeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. (2010) Diagnosis and management of iron deficiency anaemia: a clinical update. These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. Am J HealthSyst Pharm 2006;63:731735. By entering this website, you acknowledge that you are a licensed healthcare professional practicing in the United States. Serious - Use Alternative (1)iron sucrose decreases levels of moxifloxacin by inhibition of GI absorption. Diagnosis and management of iron deficiency anaemia: a clinical update. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Use Caution/Monitor. sodium citrate/citric acid will decrease the level or effect of iron sucrose by increasing gastric pH. with NDD-CKD or PDD-CKD who are on erythropoietin therapy for iron maintenance treatment, Hemodialysis-dependent chronic kidney disease (HDD-CKD)*, Non-dialysis-dependent chronic kidney disease (NDD-CKD), Peritoneal-dialysis-dependent chronic kidney disease (PDD-CKD), At a dose of 0.5 mg/kg, not to exceed 100 mg per dose, Given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at concentrations of 1 to 2 mg/mL and administered over 5 to 60 minutes, An increase in Hb concentration or a decrease in ESA dose is desired and. Applies only to oral form of both agents. Monitor Closely (1)sodium bicarbonate will decrease the level or effect of iron sucrose by increasing gastric pH. The usual total treatment course of Venofer is 1000 mg. Venofer treatment may be repeated if iron deficiency reoccurs. The iron deficit calculator is useful as one of the determinations performed before iron replenishment therapy is initiated. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Chandler G, Harchowel J, Macdougall I. 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. iron sucrose decreases levels of ofloxacin by inhibition of GI absorption. Iron Deficiency Anemia: Periodic hematologic determination (hemoglobin and hematocrit) is a simple and accurate technique for monitoring hematological response, and should be used as a guide in therapy. 1988 May;111(5):566-70. Use Caution/Monitor. This information is not individual medical advice and does not substitute for the advice of your health care professional. Iron deficit - equation derivation: Assumptions: -Blood volume = 65 mL/kg -Hemoglobin conc target =14.0 g/dL -Deficits in body stores are ignored. 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. 2012;2(4):288-335. 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. Adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight. We comply with the HONcode standard for trustworthy health information. iron sucrose decreases levels of liothyronine by inhibition of GI absorption. Copyright 1993-2021 restrictions. Separate by 2 hr. Koch TA, Myers J, Goodnough LT. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. In the text below the tool there is more information on how the iron deficit is calculated. 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. 1996 Aug;11(4):139-46. elemental iron (mg/ml) in the product being used: Where C= Divide the calculated dose by the patient's weight (IBW if BMI >30, or actual body weight (ABW) if BMI30) to ensure it does NOT exceed 20mg/kg. IMPORTANT SAFETY INFORMATION DOSAGE AND ADMINISTRATION Pediatric Patients (2 Years of Age and Older) Applies only to oral form of both agents. Use Caution/Monitor. Iron Sucrose Protocol - Cmqcc 2010;18(3). Applies only to oral form of both agents. Applies only to oral form of both agents. Give each dose as 15 mg/kg body weight for a total cumulative dose not to exceed 1500 mg of iron per course. iron sucrose decreases levels of minocycline by inhibition of GI absorption. Iron Deficiency In Pregnancy Calculator, Mean Corpuscular Hemoglobin Concentration (MCHC) Calculator. Monitor Closely (1)pantoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. The original formula employs the weight in kg but users can input it in lbs and it gets transformed. Intermediate calculations: -Blood volume (dL) = [65 (mL/kg) x body weight (kg)] / 100 (mL/dL) -Hgb deficit (g/dL) = 14.0 - patient hgb conc. 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. 2.1 Dosage - Total dose infusion The dose calculation for CosmoFer is based on patients body weight according to the table below and is diluted in 500mLs of normal saline. Properly discard this product when it is expired or no longer needed. Venofer has not been studied in patients younger than 2 years old. 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. 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. PDF Protocol for the use of Intravenous Iron Dextran (CosmoFer Venofer (iron sucrose) dose, indications, adverse effects - PDR Other indications for IV are pregnancy iron deficiency, chronic renal impairment or need for rapid repletion. J Lab Clin Med. . Venofer® (iron sucrose) injection, USP is indicated for the treatment of iron deficiency anemia (IDA) in patients with chronic kidney disease (CKD). A maximum dose of 1000 mg iron can be delivered intravenously over 15 minutes, which may make it a suitable treatment for iron-deficiency anaemia outside of the hospital setting. Applies only to oral form of both agents. Ferric gluconate: 12.5 mg/mL Schrier SL, Mentzer WC, Landaw SA. Where C= concentration of If you log out, you will be required to enter your username and password the next time you visit. Applies only to oral form of both agents. Nutr Clin Pract. 2 DOSAGE AND ADMINISTRATION 2.1 Recommended Dosage Recommended dosage for patients weighing 50kg (110lb) or more: Give Injectaferin two doses separated by at least 7 days. Accessed: 4/12/2011. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. Venofer Injection Dosage Guide - Drugs.com Monitor Closely (1)deferasirox decreases levels of iron sucrose by inhibition of GI absorption. All you have to do is use the following formula: Liquid\ dose = Dose / Medicine\ concentration Liquid dose = Dose/M edicine concentration. There are physiological variation in iron reserves such as the decrease during menstruation period. Slowing the infusion rate may alleviate symptoms. Administer Venofer early during the dialysis session (generally within the first hour). The prevention and treatment of iron deficiency is a major public health goal, especially in women, children, and individuals in low-income countries. https://www.uptodate.com/ (Requires subscription). Serious - Use Alternative (1)iron sucrose decreases levels of demeclocycline by inhibition of GI absorption. Immune system disorders: Anaphylactic-type reactions, angioedema, Nervous system disorders: Convulsions, collapse, light-headedness, loss-of-consciousness, Respiratory, thoracic and mediastinal disorders: Bronchospasm, dyspnea, Musculoskeletal and connective tissue disorders: Back pain, swelling of the joints, General disorders and administration site conditions: Hyperhidrosis, Published studies on intravenous iron sucrose treatment after first trimester of pregnancy not shown adverse maternal or fetal outcomes; available reports of intravenous iron sucrose use in pregnant women during first trimester are insufficient to assess risk of major birth defects and miscarriage; iron deficiency anemia during pregnancy should be treated because there are risks to mother and fetus associated with untreated iron deficiency anemia (IDA) in pregnancy; risks to fetus associated with maternal severe hypersensitivity reactions, Severe adverse reactions including circulatory failure (severe hypotension, shock including in the context of anaphylactic reaction) may occur in pregnant women with parenteral iron products which may cause fetal bradycardia, especially during second and third trimester, Iron sucrose is present in human milk, and available published reports following exposure to 100-300 mg intravenous iron sucrose have not reported adverse reactions in breastfed infants; there are no data on effects on milk production, Developmental and health benefits of breastfeeding should be considered, along with mothers clinical need for treatment and any potential adverse effects on breastfed child from therapy or from underlying maternal condition. The normal ranges are: for males 13.8 to 18.0 g/dL (138 to 180 g/L, or 8.56 to 11.17mmol/L) and for females 12.1 to 15.1 g/dL (121 to 151 g/L, or 7.51 to 9.37mmol/L). Use Caution/Monitor. Use Caution/Monitor. 1 Dosing for patients who weigh less than 50 kg Ferritin and transferrin are also recommended monitoring . 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 by at least 4 hours. Each mL contains 20 mg of elemental . 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. Iron deficiency anemia calculator (diagnosis), Iron deficiency anemia vs. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Applies only to oral form of both agents. commonly, these are "non-preferred" brand drugs or specialty iron sucrose, captopril. Venofer (iron sucrose) Uses, Dosage, Side Effects - Drugs.com 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. 2 Protocol for Intravenous iron sucrose - Venofer 2.1 Dosage The total cumulative dose of Venofer should be calculated using the table below. In key trials, ferric carboxymaltose increased Hb levels and replenished iron stores as effectively as IV iron sucrose . March 2, 2015 [IRON SUCROSE REQUIREMENT CALCULATION FOR SEVERE ANEMIA] DPMU Anantapuramu | National Health Mission 1 Formula for calculating the required dose of Iron sucrose 2.4 X Pre-pregnancy Weight in Kgs X Hb% deficit{11-actual Hb%} in mgs Plus Iron required to replenish the iron stores = 500mg Prepregnancy Weight = 45 kgs . Avoid or Use Alternate Drug. Applies only to oral form of both agents. Separate dosing of tetracyclines from these products. ibuprofen/famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. *Administer early during the dialysis session. This drug is available at a middle level co-pay. The cost of Venofer is $145 for a dose of 300 mg and Monoferric is $274 for a dose of 500mg. 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). Venofer is given as an infusion into a vein. Applies only to oral form of both agents. This medicine is sometimes given slowly, and the infusion can take up to 2.5 hours to complete. The dosing for iron replacement treatment in pediatric patients with HDD-CKD has not been established. The Ganzoni equation used by the iron deficiency calculator is the following: Total iron deficit (mg) = Weight in kg x (Target Hb - Actual Hb in g/dL) x 2.4 + Iron stores The recommendation is that most adults need a cumulative dose of elemental iron of at least 1 g. Observed Hb = the patients current hemoglobin in g/dl. Monitor Closely (1)calcium carbonate will decrease the level or effect of iron sucrose by increasing gastric pH. Next Steps Evidence Creator Insights Dr. Andreas M. Ganzoni About the Creator Minor/Significance Unknown. PDF Venofer Guidelines for Use 2011 - University Health System 2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion. The recipient will receive more details and instructions to access this offer. 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. INFED- iron dextran injection [Package insert], Hemoglobin iron deficit (mg) = weight (kg) x (14 - Hgb) x (2.145) Note: Hbg (current hemoglobin level) units: (g/dL) Alternatively: Volume of product required (mL) = [weight (kg) x (14 - Hgb) x (2.145)] / C Where C= concentration of elemental iron (mg/ml) in the product being used: Iron dextran: 50 mg/mL. 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. Minor/Significance Unknown. If no signs or symptoms of anaphylactic-type reactions follow the test dose, administer the full therapeutic INFeD dose. Copyright(c) 2023 First Databank, Inc. Volume of iron sucrose needed = 60 x (14 - 8) x (2.145) 20 = 38.6 mL . pantoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Modify Therapy/Monitor Closely. Individual doses of 2 mL or less may be given on a daily basis until the calculated total amount required has been reached. It is important to note that the above calculations merely provide estimates and that individual dosage should be established by a medical professional based on the current package insert for the elemental iron product used. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. This cost includes the fee charged by the pharmacy. calcium acetate decreases levels of iron sucrose by inhibition of GI absorption. Accessed: 4/12/2011. 3. ------------------------------------------------------------------------- Iron Dextran Complex [ Infed ] Elemental iron: 50 mg of elemental iron per mL [2 mL] [package insert] BOXED WARNING: WARNING: RISK FOR ANAPHYLACTIC-TYPE REACTIONS Anaphylactic-type reactions, including fatalities, have followed the parenteral administration of iron dextran injection. All Rights Reserved. iron sucrose decreases levels of levofloxacin by inhibition of GI absorption. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. concentration of elemental iron (mg/ml) in the product being used: This calculator will help pinpoint potential causes of anemia based on an automated flowchart approach. Avoid or Use Alternate Drug. Written by ASHP. -Hgb deficit (grams) = Hgb deficit (g/dL) x blood volume (dL) -Iron deficit (mg) = Hgb deficit (grams) x 3.3 (mg Fe/g Hgb) [Note: 3.3 x 0.65 = 2.145] -Volume of parenteral iron product req'd (mL) = [Iron deficit (mg)] / C(mg/mL) Final calculations: -Hgb iron deficit (mg) = weight (kg) x (14 - Hgb) x (2.145) -Volume of product required (mL) = [weight (kg)x (14 - Hgb) x (2.145)] / C Where C= concentration of elemental iron (mg/ml) in the product being used: Iron dextran: 50 mg/mL. Most adults require a cumulative dose of elemental iron of at least 1 g. Iron replenishment is usually doneintravenously, via iron-dextran, iron sucrose or iron carboxymaltose. iron sucrose decreases levels of deferiprone by enhancing GI absorption. Anemia caused by the depletion of iron is called iron deficiency anemia. Iron deficiency can occur at any stage of life, due to physiological demands, for example, during pregnancy, childhood growth or prolonged periods of sickness. Mode of Administration: Administer Venofer only intravenously by slow injection or by infusion. Avoid or Use Alternate Drug. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Separate by at least 4 hours. Where: Medicine concentration Amount of active substance per a given volume of your drug. Comparable efficacy to that of IV iron sucrose. For repletion treatment most patients may require a cumulative dose of 1000 mg of elemental iron administered over 8 dialysis sessions. HOW TO USE: This medication is given by injection into a vein as directed by your doctor. The dosage of Venofer is expressed in mg of elemental iron. Applies only to oral form of both agents. Applies only to oral form of both agents. Medscape Education, Improving Quality of Care in Patients With Iron Deficiency Anemia and Inflammatory Bowel Disease, 2010feosol-carbonyl-fe-icar-c-carbonyl-iron-342171Drugs, encoded search term (iron sucrose (Venofer)) and iron sucrose (Venofer), Use of High-Dose Iron in Dialysis in US Tracks PIVOTAL Trial, FDA Watch List Adds Drugs With Anaphylaxis, Herpes, Fetal Death Risk, Dialysis Industry Mergers: Profits Rise as Patient Outcomes Worsen, Hematology-Oncology Guidelines: 2017 Midyear Review. Minor/Significance Unknown. iron sucrose will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Dosage: For patients weighing 50 kg (110 lb) or more: Give Injectafer in two doses separated by at least 7 days. MDCalc loves calculator creators researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice.