Iron Sucrose (Venofer)
Nutritive Agent | Parenteral Component
- Indication and Dosage: Venofer is primarily used for the treatment of iron deficiency anemia in patients with chronic kidney disease (CKD). The dosage varies based on the patient’s iron status and hemoglobin levels, typically ranging from 100 mg to 300 mg, administered intravenously.
- Administration Guidelines: Venofer should be administered slowly as an intravenous injection or infusion. For IV injection, it should not exceed 100 mg per dose and must be given over at least 5 minutes. For IV infusion, doses greater than 100 mg should be diluted in a maximum of 250 mL of 0.9% saline and infused over a period not less than 15 minutes.
- Monitoring: Close monitoring of hemoglobin, ferritin, and transferrin saturation is recommended before, during, and after treatment with Venofer. This monitoring helps in assessing the response to therapy and in preventing iron overload, which can be dangerous.
- Hypersensitivity Reactions: Be aware of the potential for serious hypersensitivity reactions, including anaphylaxis. Pre-medication with antihistamines or corticosteroids should be considered for patients with a history of multiple drug allergies or severe asthma.
- Interactions: Phosphate binders (used by patients with CKD) can decrease the absorption of oral iron preparations, but Venofer, being administered intravenously, bypasses the gut and this interaction. However, vigilance is required for possible drug interactions with other IV formulations.
- Pregnancy and Lactation: Venofer is classified as pregnancy category B. It should only be used during pregnancy if clearly needed, and the potential benefit justifies the potential risk to the fetus. Only negligible amounts of iron sucrose are excreted into breast milk.
- Stability and Storage: Venofer should not be mixed with other drugs or added to parenteral nutrition solutions to avoid compatibility issues. Proper storage conditions involve keeping it at room temperature and protecting it from freezing.
- Adverse Effects: Common adverse effects include diarrhea, cramps, nausea, vomiting, headache, dizziness, and hypotension. Patients should be monitored for signs of these effects during and after administration.
- Cost-effectiveness: In comparison to other IV iron therapies, Venofer can be cost-effective, considering the dosing and reduced frequency of clinic visits required for administration. However, a thorough pharmacoeconomic evaluation based on the patient's specific conditions and needs is advisable.
- Educate Patients: Inform patients about the importance of completing the treatment course and adhering to follow-up appointments for lab work. Educating them on the signs of iron overload and hypersensitivity reactions is also crucial to ensure timely intervention.
Did you find this clinical pearl helpful?
