iron sucrose (Rx)

Brand and Other Names:Venofer
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 20mg (Fe)/mL

Iron Deficiency Anemia

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)

Dosage Forms & Strengths

injectable solution

  • 20mg (Fe)/mL

Iron Deficiency Anemia

Indicated for maintenance treatment of iron-deficient anemia associated with chronic kidney disease

<2 years: Safety and efficacy not established

≥2 years

  • Hemodialysis-dependent: 0.5 mg/kg IV q2weeks for 12 weeks; not to exceed 100 mg/dose
  • Non-dialysis dependent or peritoneal-dependent (on erythropoietin): 0.5 mg/kg IV q4weeks for 12 weeks; not to exceed 100 mg/dose

Dosing Considerations

Iron replacement treatment in pediatric patients has not been established

Next:

Interactions

Interaction Checker

and iron sucrose

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Hypotension (36%)

            Muscle cramps (23%)

            Headache

            Nausea

            1-10%

            Dizziness

            Fatigue

            Arthralgia

            Back pain

            Hypertension

            Fluid overload

            Peripheral edema

            Cough

            Vomiting

            Diarrhea

            Constipation

            Pruritus

            Frequency Not Defined

            Potentially fatal anaphylaxis (rare)

            Iron overload

            Immune system disorders: Anaphylactic-type reactions, angioedema

            Psychiatric disorders: Confusion

            Nervous system disorders: Convulsions, collapse, light-headedness, loss-of-consciousness

            Cardiac disorders: Bradycardia

            Vascular disorders: Shock

            Respiratory, thoracic and mediastinal disorders: Bronchospasm, dyspnea

            Musculoskeletal and connective tissue disorders: Back pain, swelling of the joints

            Renal and urinary disorders: Chromaturia

            General disorders and administration site conditions: Hyperhidrosis

            Previous
            Next:

            Warnings

            Contraindications

            Hypersensitivity

            Anemia not caused by iron deficiency

            Iron overload

            Cautions

            Risk of hypotension

            Withhold therapy in tissue iron overload

            Hypersensitivity

            • Serious hypersensitivity reactions reported, including anaphylactic-type reactions, some of which have been life-threatening and fatal
            • Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse
            • If hypersensitivity reactions or signs of intolerance occur during administration, stop infusion immediately
            • Monitor patients for signs and symptoms of hypersensitivity during and after administration for at least 30 minutes and until clinically stable following completion of the infusion
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            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

            Animal data

            • Animal reproduction studies of iron sucrose administered to rats and rabbits during period of organogenesis at elemental iron doses equivalent to maximum recommended human dose based on body surface area revealed no evidence of harm to the fetus; adverse outcomes in pregnancy occur regardless of health of mother or use of medications
            • Iron deficiency anemia during pregnancy should be treated; untreated IDA in pregnancy is associated with adverse maternal outcomes such as post-partum anemia; adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight

            Lactation

            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 mother’s clinical need for treatment and any potential adverse effects on breastfed child from therapy or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin

            Pharmacokinetics

            Half-life elimination: 6 hr

            Vd: 7.9-10 L

            Clearance: 1.2 L/hr

            Excretion: Urine (5%)

            Previous
            Next:

            Administration

            IV Incompatibilities

            Do not mix with other medications or add to parenteral nutrition solutions for IV infusion

            IV Compatibilities

            Solution: 0.9% NaCl

            IV Preparation

            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 (25°C)

            Adults

            • HD-dependent and non-dialysis-dependent CKD: Dilute with up to 100 mL of 0.9% NaCl
            • PD-dependent CKD: Dilute with up to 250 mL of 0.9% NaCl

            Pediatrics

            • Dilute in 25 mL of 0.9% NaCl

            IV Administration

            Adults

            • HD-dependent CKD
              • Undiluted: Administer by slow IV injection over 2-5 min
              • Diluted solutions: Administer IV over 15 min
            • Non-dialysis-dependent CKD
              • Undiluted: Administer by slow IV injection over 2-5 min
              • Diluted solutions: Administer IV over 15 min
            • PD-dependent CKD
              • 300 mg doses: Infuse IV over 1.5 hr
              • 400 mg dose: Infuse IV over 2.5 hr

            Pediatric

            • Undiluted: Administer by slow IV injection over 5 minutes
            • Diluted solutions: Administer IV over 5-60 minutes

            Storage

            Unused vials

            • Store in original carton at 20-25°C (68-77° F); excursions permitted to 15- 30°C (59-86°F)
            • Do not freeze

            Diluted solutions

            • Syringe: Store at room temperature (25°C) or under refrigeration (4°C) for up to 7 days
            • IV infusion: Store at room temperature (25°C) for up to 7 days
            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.