Iron Hydroxide Sucrose Complex Pharmacology
Iron Hydroxide Sucrose Complex
Fe sucrose (ferric hydroxide in complex w/ sucrose), Hematinic.
2.Metabolism: Following IV administration, iron sucrose dissociated into iron and sucrose by the reticuloendothelial system.
3.Elimination:The sucrose component is eliminated mainly by urinary excretion.
12.Elevated liver enzymes
15.Application site reaction
2.Patients with known hypersensitivity to iron sucrose or any of its inactive components
3.Patients with anemia not caused by iron deficiency.
2.Patients receiving iron sucrose requires periodic monitoring of hematologic and hematinic parameters.
3.Iron therapy should be withheld in patients with evidence of iron overload.
4.Transferrin saturation values increase rapidly after IV administration of iron sucrose; thus, serum iron values may be reliably obtained 48 hrs after IV dosing.
5.Hypersensitivity Reactions: Serious hypersensitivity reactions have been rarely reported in patients receiving iron sucrose.
6.Hypotension: Hypotension has been reported in chronic kidney disease patients receiving IV iron. Hypotension following administration of iron sucrose may be related to rate of administration and total dose administered. Caution should be taken to administer iron sucrose according to recommended guidelines.
7.Administration: Iron sucrose must only be administered IV either by slow injection or by infusion.
1.Hemodialysis Dependent Chronic Kidney Disease patients receiving an erythropoietin.
2.Peritoneal Dialysis Dependent Chronic Kidney Disease patients receiving an erythropoietin.
3.Non-Dialysis Dependent Chronic Kidney Disease patients receiving or not receiving an erythropoietin.
1.Hemodialysis-Dependent Chronic Kidney Disease: Recommended Dose: 100 mg (5 mL) administered 1-3 times/week;
Slow IV Injection: Iron sucrose may be administered undiluted by slow IV injection into the dialysis line over 2-5 min.
Infusion: Iron sucrose may be administered by infusion (into the dialysis line for hemodialysis patients) as every 5 mL iron sucrose diluted exclusively in a maximum of 100 mL of 0.9% NaCl, immediately prior to infusion. The solution must be infused at a rate of 100 mg of iron over a period of at least 15 min. Unused diluted solution must be discarded.
2.Non-Dialysis Dependent Chronic Kidney Disease: Iron sucrose is administered as a total cumulative dose of 1000 mg over a 14-day period as a 200 mg slow IV injection undiluted over 2-5 min on 5 different occasions within the 14 days period. There is limited experience with administration of an infusion of 500 mg of iron sucrose, diluted in a maximum of 250 mL of 0.9% NaCl, over a period of 3.5-4 hrs on day 1 and 14.
3.Peritoneal Dialysis Dependent Chronic Kidney Disease: Iron sucrose is infused IV in 3 divided doses for a total dose of 1000 mg during a 28-day period: 2 infusions of 300 mg over 1.5 hrs 14 days apart, followed by one 400-mg infusion over 2.5 hrs 14 days later.
Symptoms associated with overdosage or infusing iron sucrose too rapidly included hypotension, dyspnea, headache, vomiting, nausea, dizziness, joint aches, paresthesia, abdominal and muscle pain, edema and cardiovascular collapse.
Treatment: Most symptoms have been successfully treated with IV fluids, hydrocortisone and/or antihistamines. Infusing the solution as recommended or at a slower rate may also alleviate symptoms.
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