Iron sucrose
Iron Sucrose is used as a source of iron in patients with iron deficiency anemia with chronic kidney disease (CKD), including those who are undergoing dialysis (hemodialysis or peritoneal) and those who do not require dialysis. Due to less side effects than iron dextran, iron Sucrose is more preferred in chronic kidney disease patients.
Mechanism of effect
Following intravenous administration, iron Sucrose is dissociated into iron and sucrose and the iron is transported as a complex with transferrin to target cells including erythroid precursor cells. The iron is then incorporated into hemoglobin as the cells mature into red blood cells.
Pharmacodynamic
Significant increases in serum iron and serum ferritin and significant decreases in total iron binding capacity occurred four weeks from the initiation of iron sucrose treatment.
Pharmacokinetics
- Half-life elimination: 6 hr
- Vd: 7.9-10 L
- Clearance: 1.2 L/hr
- Excretion: Urine (5%)
Drug indications
anemiaDosage
Adult
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)
Pediatric
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
Drug contraindications
HypersensitivitySide effects
Diarrhea , Headache , nausea , vomiting , vertigo , Hypertension , Peripheral edema , itching , Muscle cramps , tirednessInteractions
Penicillamine , Lisinopril , Captopril , Chloramphenicol , Fosinopril , Ramipril , Trandolapril , Perindopril , Dimercaprol , Ferrous Gluconate , Moexipril , quinapril , Demeclocycline , Eltrombopag , DexlansoprazoleAlerts
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
Points of recommendation
- Avoid driving and doing other tasks or actions that call for you to be alert until you see how iron sucrose affects you.
- To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- Very bad and sometimes deadly allergic side effects have rarely happened. Talk with your doctor.
- Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using iron sucrose while you are pregnant.
- Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
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