Iron Hydroxide Sucrose Complex Pharmacology

Iron Hydroxide Sucrose Complex

About Iron Hydroxide Sucrose Complex
Parenteral iron preparation, Antianemic,hematinic.
Fe sucrose (ferric hydroxide in complex w/ sucrose), Hematinic.

Mechanism of Action of Iron Hydroxide Sucrose Complex
Following IV administration, iron sucrose is dissociated by the reticuloendothelial system into iron and sucrose.
Pharmacokinets of Iron Hydroxide Sucrose Complex
1.Distribution: Following IV administration of iron sucrose, the iron component appears to distribute mainly in blood and to some extent in extravascular fluid. Significant amount of administered iron is distributed in the liver, spleen and bone marrow.
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.
Onset of Action for Iron Hydroxide Sucrose Complex
N/A
Duration of Action for Iron Hydroxide Sucrose Complex
N/A
Half Life of Iron Hydroxide Sucrose Complex
6 hrs
Side Effects of Iron Hydroxide Sucrose Complex
1.Hypotension
2.Chest pain
3.Hypertension
4.Hypervolemia
5.CHF
6.Cramps
7.Musculoskeletal pain
8.Diarrhea
9.Nausea
10.Vomiting
11.Abdominal pain
12.Elevated liver enzymes
13.Skin irritation
14.Pruritis
15.Application site reaction
16.Dizziness
17.Dyspnea
18.Pneumonia
19.Cough
20.Headache
21.Fever
22.Asthenia
23.Malaise.
Contra-indications of Iron Hydroxide Sucrose Complex
1.Patients with evidence of iron overload
2.Patients with known hypersensitivity to iron sucrose or any of its inactive components
3.Patients with anemia not caused by iron deficiency.
Special Precautions while taking Iron Hydroxide Sucrose Complex
1.Because body iron excretion is limited and excess tissue iron can be hazardous, caution should be exercised to withhold iron administration in the presence of evidence of tissue iron overload.
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.
Pregnancy Related Information
Use with caution
Old Age Related Information
There are no identified differences in responses between elderly and younger patients, but greater sensitivity of some of the older individuals cannot be ruled out.
Breast Feeding Related Information
Use with caution
Children Related Information
Not recommended
Indications for Iron Hydroxide Sucrose Complex
Treatment of iron deficiency anemia in the following patients:
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.
Interactions for Iron Hydroxide Sucrose Complex
Iron sucrose should not be administered concomitantly with oral iron preparations since the absorption of oral iron is reduced.
Typical Dosage for Iron Hydroxide Sucrose Complex
Each mL containing 20 mg of elemental iron should be used in
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.
Schedule of Iron Hydroxide Sucrose Complex
N/A
Storage Requirements for Iron Hydroxide Sucrose Complex
Store at temperatures not exceeding 30?C. Do not freeze.
Effects of Missed Dosage of Iron Hydroxide Sucrose Complex
N/A
Effects of Overdose of Iron Hydroxide Sucrose Complex
Dosages of iron sucrose in excess of iron needs may lead to accumulation of iron in storage sites leading to hemosiderosis. Periodic monitoring of iron parameters eg, serum ferritin and transferrin saturation may assist in recognizing iron accumulation. Iron sucrose should not be administered to patients with iron overload and should be discontinued when serum ferritin levels equal or exceed established guidelines. Particular caution should be exercised to avoid iron overload where anemia unresponsive to treatment has been incorrectly diagnosed as iron deficiency anemia.
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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