iron sucrose (redirected from Venofer)

iron sucrose,

a complex of ferric hydroxide, Fe(OH)₃, in sucrose, used intravenously to treat iron deficiency anemia in hemodialysis patients receiving supplemental erythropoietin therapy.

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iron sucrose

Venofer

Pharmacologic class: Trace element

Therapeutic class: Iron supplement

Pregnancy risk category B

Action

Replenishes depleted stores of iron (a component of hemoglobin) in bone marrow

Availability

Aqueous complex for injection: 20 mg elemental iron/ml in 5-ml single-use vials (100 mg of elemental iron)

⊘Indications and dosages

➣ Iron-deficiency anemia in hemodialysis patients concurrently receiving erythropoietin

Adults: 100 mg of elemental iron (5 ml) I.V. directly into dialysis line or by slow injection or infusion during dialysis session (up to three times weekly) for 10 doses (total of 1,000 mg)

Off-label uses

• Autologous blood donation
• Bloodless surgery

Contraindications

• Hypersensitivity to drug, alcohol, tartrazine, or sulfites
• Hemolytic anemias and other anemias not caused by iron deficiency
• Primary hemochromatosis

Precautions

Use cautiously in:
• autoimmune disorders, arthritis, severe hepatic impairment
• elderly patients
• breastfeeding patients
• children.

Administration

• Give test dose only if ordered: 50 mg (2.5 ml) I.V. over 3 to 10 minutes.
• Dilute 100 mg of elemental iron in no more than 100 ml of normal saline solution; infuse slowly I.V. over at least 15 minutes.
• Administer I.V. directly into dialysis line or by infusion at 20 mg/minute, not to exceed 100 mg/injection.
• Don't give with oral iron preparations.

Route	Onset	Peak	Duration
I.V.	4 days	1-2 wk	Wks-mos

Adverse reactions

CNS: dizziness, headache, syncope, seizures

CV: chest pain, tachycardia, hypotension

GI: nausea, vomiting

Hematologic: hemochromatosis, hemolysis, hemosiderosis

Musculoskeletal: muscle cramps, aches, or weakness; joint pain

Respiratory: dyspnea

Other: abnormal or metallic taste, tooth discoloration, fever, lymphadenopathy, allergic reactions including anaphylaxis

Interactions

None significant

Patient monitoring

☞ Monitor for hypersensitivity reaction. Keep epinephrine and other emergency supplies available in case reaction occurs.
• Assess hemoglobin, hematocrit, serum ferritin, and transferrin saturation levels before, during, and after therapy.
☞ Monitor blood pressure. Stay alert for hypotension.
• Watch for signs and symptoms of iron overload, such as decreased activity, sedation, and GI or respiratory tract bleeding.

Patient teaching

• Caution patient not to take oral iron preparations or vitamin supplements containing iron during therapy.
• Instruct patient to report dyspnea, itching, or rash.
• Tell patient he'll undergo periodic blood testing to monitor his response to therapy.
• As appropriate, review all other significant and life-threatening adverse reactions mentioned above.