Separate by 2 hr. Applies only to oral form of both agents. Applies only to oral form of both agents. Dosing: (a) Divide calculated total cumulate dose . Each mL contains 20 mg of elemental iron. 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. If either is present, do not use the liquid. 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. Follow your doctor's directions carefully.Tell your doctor right away if you have any serious side effects, including: abdominal pain, chest pain, irregular heartbeat (arrhythmias), pressure in the chest, severe headache and blurred vision (hypertension), problems with your dialysis access site (graft).A very serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Pain, swelling, or redness at the injection site may occur. Use Caution/Monitor. Most reactions associated with intravenous iron preparations occur within 30 minutes of the completion of the infusion. 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. Although the original formula requires the weight in kilograms, values input in lbs are transformed. Intermediate calculations: -Blood volume (dL) = [65 (mL/kg) x body weight (kg)] / 100 (mL/dL) -Hgb deficit (g/dL) = 14.0 - patient hemoglobin conc. By clicking send, you acknowledge that you have permission to email the recipient with this information. 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. Excessive dosages of Venofer may lead to accumulation of iron in storage sites potentially leading to hemosiderosis. Applies only to oral form of both agents. Otherwise, call a poison control center right away. Dosing Administration & Considerations . Use Caution/Monitor. 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. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. The dosage is expressed in terms of mg of elemental iron, with each mL of Feraheme containing 30 mg of elemental iron. Use Caution/Monitor. Iron sucrose: 20 mg/mL. Do not administer Venofer to patients with iron overload. Canada residents can call a provincial poison control center. Applies only to oral form of both agents. 10th ed. Applies only to oral form of both agents. Uses for Iron Sucrose Minor/Significance Unknown. . For repletion treatment most patients may require a cumulative dose of 1000 mg of elemental iron administered over 8 dialysis sessions. 1000 mg. 20 MINUTES. Applies only to oral form of both agents. Intravenous therapy is preferred for urgent intervention and when oral iron cannot be absorbed or the patient suffers from chronic renal impairment. Iron deficiency anemia calculator (diagnosis), Iron deficiency anemia vs. Applies only to oral form of both agents. Applies only to oral form of both agents. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Applies only to oral form of both agents. 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. When administered via infusion, dilute up to 750 mg of iron in no more than 250 mL of sterile 0.9% sodium chloride injection, USP, such that the concentration of the infusion is not less than 2 mg of iron per mL and administer over at least 15 minutes. Dilute Venofer in a maximum of 250 mL of 0.9% NaCl [see How Supplied/Storage and Handling (16.2).] Use Caution/Monitor. Applies only to oral form of both agents. Volume of iron product required = 25 mL. Minor/Significance Unknown. Applies only to oral form of both agents. 4. Ferumoxytol [ Feraheme ] Elemental iron: 510 mg/17 mL (17 mL) 30 mg/mL [package insert] - Boxed warning REVIEW INSERT. 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. These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. Nutr Clin Pract. Monitor Closely (1)deferoxamine decreases levels of iron sucrose by inhibition of GI absorption. Use INFeD only in patients in whom clinical and laboratory investigations have established an iron deficient state not amenable to oral iron therapy. Accessed: 4/12/2011. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. The primary endpoint was the proportion of patients with . WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS Fatal and serious hypersensitivity reactions including anaphylaxis have occurred in patients receiving Feraheme. Avoid or Use Alternate Drug. Use Caution/Monitor.Minor (2)calcium carbonate decreases levels of iron sucrose by inhibition of GI absorption. Administer on 5 different occasions over a 14 day period. Anemia; 2015: 763576. For patients receiving hemodialysis, administer Feraheme once the blood pressure is stable and the patient has completed at least one hour of hemodialysis. 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. Serious - Use Alternative (1)iron sucrose decreases levels of doxycycline by inhibition of GI absorption. Use Caution/Monitor. Only administer Venofer when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. Avoid or Use Alternate Drug. 1. Serum iron, total iron binding capacity (TIBC) and percent saturation of transferrin are other important tests for detecting and monitoring the iron deficient state. Minor/Significance Unknown. The dosing for iron replacement treatment in pediatric patients with HDD-CKD has not been established. Anaphylaxis may occur with IV iron and resuscitation facilities should be available.11 It would appear that iron polymaltose may have a higher incidence of severe systemic reactions than iron sucrose and ferric carboxymaltose. Avoid or Use Alternate Drug. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 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. David McAuley, Pharm.D. Before using, check this product visually for particles or discoloration. Avoid or Use Alternate Drug. Deferoxamine chelates iron. Recommended Treatment Regimen Using IV Iron Sucrose for Initial Repletion in Children With Iron Deficiency Anemia. 1998 Feb;25(1):65-8. iron sucrose decreases levels of fleroxacin by inhibition of GI absorption. Introduction Uses Dosage Warnings Interactions Stability Introduction Hematinic agent; a polynuclear iron (III)-hydroxide sucrose complex. In this study and another study evaluating a single intravenous dose of iron sucrose containing 500-700 mg of iron in 26 anemic patients on erythropoietin therapy (23 female, 3 male; age range 16-60), approximately 5% of the iron was . VenAccess is a trademark of Vifor (International) Inc. Switzerland. Venofer treatment may be repeated if necessary. The elemental iron product used is Iron sucrose 20 mg/mL. https://www.uptodate.com/ (Requires subscription). Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. 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. Administer while the patient is in a reclined or semi-reclined position. 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. Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD): Administer Venofer 100 mg undiluted as a slow intravenous injection over 2 to 5 minutes, or as an infusion of 100 mg diluted in a maximum of 100 mL of 0.9% NaCl over a period of at least 15 minutes, per consecutive hemodialysis session. Interaction only with oral iron administration. Use Caution/Monitor. Most Intravenous Injection - PRIOR TO THE FIRST INTRAVENOUS INFeD THERAPEUTIC DOSE, ADMINISTER AN INTRAVENOUS TEST DOSE OF 0.5 ML. 1988 May;111(5):566-70. Most Applies only to oral form of both agents. Monitor Closely (1)omeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. Either decreases levels of the other by inhibition of GI absorption. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Where C= concentration of Use Caution/Monitor. Applies only to oral form of both agents. Use Caution/Monitor. Monitor Closely (1)iron sucrose will decrease the level or effect of omadacycline by inhibition of GI absorption. 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. iron sucrose, captopril. Use Caution/Monitor. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. Iron deficiency anemia is the type of anemia caused by iron depletion. Use Caution/Monitor. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. . 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. sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of iron sucrose by inhibition of GI absorption. Andreas M. Ganzoni, MD, is a physician and researcher in the internal medicine department at the University of Zurich in Zurich, Switzerland. World J Gastroenterol; 16(22): 27202725. sodium bicarbonate will decrease the level or effect of iron sucrose by increasing gastric pH. Minor/Significance Unknown. Use Caution/Monitor. The iron deficit calculator is useful as one of the determinations performed before iron replenishment therapy is initiated. Applies only to oral form of both agents. Monitor Closely (1)iron sucrose decreases levels of deferiprone by enhancing GI absorption. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Minor/Significance Unknown.iron sucrose increases levels of calcium acetate by enhancing GI absorption. Intravenous iron-dextran: therapeutic and experimental possibilities. These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. Venofer [package insert]. . DOSAGE AND ADMINISTRATION: The recommended dose of Feraheme is an initial 510 mg dose followed by a second 510 mg dose 3 to 8 days later. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. 1. Anemia. Share cases and questions with Physicians on Medscape consult. Max Dose. Serious - Use Alternative (1)iron sucrose decreases levels of ciprofloxacin by inhibition of GI absorption. Use Caution/Monitor. 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. Use Caution/Monitor. 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 This information is not individual medical advice and does not substitute for the advice of your health care professional. Monitor Closely (1)iron sucrose decreases levels of ibandronate by inhibition of GI absorption. Generic name: IRON SUCROSE 20mg in 1mL To view formulary information first create a list of plans. Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf. All Rights Reserved. iron sucrose decreases levels of mycophenolate by inhibition of GI absorption. didanosine will decrease the level or effect of iron sucrose by increasing gastric pH. Venofer® (iron sucrose) injection, USP is indicated for the treatment of iron deficiency anemia (IDA) in patients with chronic kidney disease (CKD). Applies only to oral form of both agents. Applies only to oral form of both agents. 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% . Applies only to oral form of both agents. Applies only to oral form of both agents. Venofer must only be administered intravenously either by slow injection or by infusion. The factor 2.4 is derived from the following assumptions: a) Blood volume 70 ml/kg of body weight ~7% of body weight b) Iron content of hemoglobin 0.34% Factor 2.4 = 0.0034 x 0.07 x 10000 (conversion for g/dL) Ganzoni AM. ADMINISTER THE TEST DOSE AT A GRADUAL RATE OVER AT LEAST 30 SECONDS. Separate by 2 hr. Use Caution/Monitor. Hemodialysis-dependent CKD: 100 mg elemental iron IV (injection or infusion over 2-5 min) per dialysis session not to exceed total cumulative dose of 1000 mg divided in 3 doses/week. Separate dosing of tetracyclines from these products. Monitor Closely (1)didanosine will decrease the level or effect of iron sucrose by increasing gastric pH. 1990 Feb;24(2):162-6. Am J Kid Dis 2001; 38 988991. Maximum single dose of iron sucrose to be given at a time in Non-dialysis CKD patients is 500 mg but with limited experience. iron sucrose decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Prior to and at regular intervals during parenteral iron therapy, evaluate serum iron, hemoglobin, and hematocrit. Do not administer Venofer to patients with evidence of iron overload. A target haemoglobin value is also input so iron deficit can be determined according to a specified individual target. The cost of Venofer is $145 for a dose of 300 mg and Monoferric is $274 for a dose of 500mg. Indicated for treatment of iron deficiency anemia associated with chronic kidney disease, Hemodialysis-dependent CKD: 100 mg elemental iron IV (injection or infusion over 2-5 min) per dialysis session not to exceed total cumulative dose of 1000 mg divided in 3 doses/week, Non-dialysis-dependent CKD: 200 mg IV injection for 5 doses in over 14 days (cumulative 1000 mg in 14-day period), Peritoneal dialysis-dependent CKD: 300 mg IV infusion (1.5 hr) for 2 doses 14 days apart, THEN 400 mg IV infusion (2.5 hr) 14 days later (cumulative 1000 mg divided in 3 doses/week), Indicated for maintenance treatment of iron-deficient anemia associated with chronic kidney disease, <2 years: Safety and efficacy not established, Iron replacement treatment in pediatric patients has not been established. The dosage of Venofer is expressed in mg of elemental iron. Applies only to oral form of both agents. 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. Minor/Significance Unknown. Serious - Use Alternative (1)iron sucrose will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. 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. Drug Des Devel Ther; 5: 5160. . Iron stores are input as default 500 mg on the assumption that the patient weight is greater or equal to 35 kg (77 lbs). Safety of highdose iron sucrose infusion in hospitalized patients with chronic kidney disease. Here are the steps to follow for using this drug dosage calculator: First, enter the value of your Weight and choose the unit of measurement from the drop-down menu. * Calculators are available in UpToDate to determine ideal body weight and lean body weight. Evaluate the hematologic response (hemoglobin, ferritin, iron and transferrin saturation) at least one month following the second Feraheme infusion. Applies only to oral form of both agents. Venofer is indicated for the treatment of iron deficiency anemia (IDA) in patients with chronic kidney disease (CKD). After administration of iron dextran complex, evidence of a therapeutic response can be seen in a few days as an increase in the reticulocyte count. The initial hemoglobin rise is more rapid with parenteral iron but on the long term (12 weeks), both therapies reach similar levels of hemoglobin. Applies only to oral form of both agents. For patients weighing less than 50 kg (110 lb): Give Injectafer in two doses separated by at least 7 days. Calculates iron deficit for dosing iron. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Intravenous therapy is usually recommended in case of contraindications to oral iron, comorbidities that prevent absorption, chronic renal impairment or iron replacement needs to be rapid. Applies only to oral form of both agents. The prevention and treatment of iron deficiency is a major public health goal, especially in women, children, and individuals in low-income countries. iron sucrose decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. 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. 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. We first individually analyzed 5 clinical studies, averaging the total iron deficit across all patients utilizing a . Applies only to oral form of both agents. The dosing for iron replacement treatment in pediatric patients with Peritoneal or Hemodialysis-Dependent - CKD or Non-Dialysis Dependent CKD have not been established. For adult CKD patients on ESA therapy who are not receiving iron supplementation, the guideline suggests a trial of IV iron (or in NDD-CKD patients, alternatively, a 1- to 3-month trial of oral iron therapy) if: CKD=chronic kidney disease ESA=erythropoietin-stimulating agent Hb=hemoglobin IV=intravenous RBC=red blood cell WBC=white blood cell. Adult Dosage and Administration: The recommended dosage of Ferrlecit for the repletion treatment of iron deficiency in hemodialysis patients is 10 mL of Ferrlecit (125 mg of elemental iron). gymnema decreases levels of iron sucrose by inhibition of GI absorption. Kumpf VJ, Holland EG. Hemoglobin there are two fields for hemoglobin input, one for the target and another for actual value. Use alternatives if available. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. iron sucrose decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Hemoglobin can be input in g/dL, g/L or mmol/L and refers to the amount of hemoglobin in the red blood cells.
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