in the colostrum of 10 iron deficient breastfeeding women who were 2 to 3 days postpartum and received a single dose of 100 mg of intravenous iron . View the formulary and any restrictions for each plan. Iron supplements, regardless of their way of administration, are used to replete body stores and to correct anemia. Sodium ferric gluconate complex injection [ Ferrlecit ] [package insert] - Elemental iron: 12.5 mg/mL (5 mL). Avoid or Use Alternate Drug. All adult and pediatric patients receiving Venofer require periodic monitoring of hematologic and iron parameters (hemoglobin, hematocrit, serum ferritin and transferrin saturation). * Adapted from the KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. The plasma ferritin level as a reliable index of body iron stores following intravenous iron dextran. Serious - Use Alternative (1)iron sucrose decreases levels of minocycline by inhibition of GI absorption. Minor/Significance Unknown. cimetidine will decrease the level or effect of iron sucrose by increasing gastric pH. Avoid or Use Alternate Drug. Do not administer Venofer to patients with evidence of iron overload. Monitor Closely (1)famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. Methods. Untreated IDA in pregnancy is associated with adverse maternal outcomes such as post-partum anemia. Baloxavir may bind to polyvalent cations resulting in decreased absorption. 2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion. Applies only to oral form of both agents. 2010; 193(9):525-32. Venofer may reduce the absorption of concomitantly administered oral iron preparations. Applies only to oral form of both agents. Applies only to oral form of both agents. Compare formulary status to other drugs in the same class. STORAGE: Consult the product instructions and your pharmacist for storage details. Intravenous (IV) iron products (use in adults) Dosing information in this table is for adults and includes some dosing recommendations not listed in the approved product information. Most Applies only to oral form of both agents. 0.5 mg/kg (not to exceed 100 mg/dose) diluted to a concentration of 1 to 2 mg/mL in 0.9% sodium chloride IV over 5 to 60 minutes Administer every 4 weeks for 12 weeks Do not dilute to concentrations below 1 mg/mL Comments: Treatment may be repeated if necessary. aluminum hydroxide will decrease the level or effect of iron sucrose by increasing gastric pH. Equations : Total body iron deficit (mg) = body weight (kg) x (target Hb - actual Hb in g/dL) x 2.4 + iron depot (mg)** [1, 2] Iron depot: 15 mg/kg for body weight less than 35 kg 500 mg for those with a body weight greater than or equal to 35 kg Ideal Body Weight (kg) =45.5 +2.3 * (height inches - 60 inches) [3] Consult your doctor before breast-feeding. 2022 American Regent, Inc.PP-VE-US-0016 (v6.0)1/2022. The total amount of INFeD in mL required to treat the anemia and replenish iron stores may be approximated as follows: Adults and Children over 15 kg (33 lbs): See Dosage Table. Parenteral iron product is iron sucrose (C = 20 mg elemental iron/mL). Hanson DB, Hendeles L. Guide to total dose intravenous iron dextran therapy. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. This website also contains material copyrighted by 3rd parties. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Suggested regime: Prescribing instructions Prescribing a single/first dose: 0.5 mg/kg/min (0.005 mL/kg/min) Maximum infusion rate (if tolerated) Increase to 8 mg/kg/min (0.08 mL/kg/min) Monitor the patient's vital signs throughout the infusion. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Use Caution/Monitor. Separate dosing of tetracyclines from these products. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. When to Use Weight lbs Target hemoglobin g/dL Actual hemoglobin g/dL Iron stores Use 500 mg for adults and children 35 kg; use 15 mg/kg if <35 kg mg Result: Please fill out required fields. For adult CKD patients on ESA therapy who are not receiving iron supplementation, the guideline suggests a trial of IV iron (or in NDD-CKD patients, alternatively, a 1- to 3-month trial of oral iron therapy) if: CKD=chronic kidney disease ESA=erythropoietin-stimulating agent Hb=hemoglobin IV=intravenous RBC=red blood cell WBC=white blood cell. Minor (2)calcium gluconate decreases levels of iron sucrose by inhibition of GI absorption. Monitor Closely (1)iron sucrose decreases levels of methyldopa by inhibition of GI absorption. PDF Treatment Guideline - Gloucestershire Royal Hospital Pediatric Patients (2 Years of Age and Older). Use Caution/Monitor. 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), Indicated for maintenance treatment of iron-deficient anemia associated with chronic kidney disease, <2 years: Safety and efficacy not established, Iron replacement treatment in pediatric patients has not been established. Oral and parenteral products - see background option for oral products. Separate dosing of tetracyclines from these products. Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron sucrose by inhibition of GI absorption. Applies only to oral form of both agents. Where C is the concentration of the iron product: Please note that the calculations above are for information purposes only and the individual dose needs to be established by taking into account the current package insert for the elemental iron product used. 2. trientine, iron sucrose. 1974 Jun;31(6):592-5. Fatal reactions have also occurred in situations where the test dose was tolerated. official version of the modified score here. iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. Do not double the dose to catch up. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. The dosing for iron replacement treatment in pediatric patients with HDD-CKD has not been established. ------------------------------------------------------------------------- Iron Dextran Complex [ Infed ] Elemental iron: 50 mg of elemental iron per mL [2 mL] [package insert] BOXED WARNING: WARNING: RISK FOR ANAPHYLACTIC-TYPE REACTIONS Anaphylactic-type reactions, including fatalities, have followed the parenteral administration of iron dextran injection. I. ADMINISTER THE TEST DOSE AT A GRADUAL RATE OVER AT LEAST 30 SECONDS. During all INFeD administrations, observe for signs or symptoms of anaphylactic-type reactions. PDF Protocol for the use of Intravenous Iron Dextran (CosmoFer Use Caution/Monitor. Use Caution/Monitor. Applies only to oral form of both agents. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Minor/Significance Unknown. To view formulary information first create a list of plans. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. If you have private insurance, Venofer or Monoferric may be on the list of covered medications. Monitor Closely (1)calcium carbonate will decrease the level or effect of iron sucrose by increasing gastric pH. Dosage: For patients weighing 50 kg (110 lb) or more: Give Injectafer in two doses separated by at least 7 days. A: Generally acceptable. The iron formulation choice remains for the clinician to make. iron sucrose, captopril. Avoid or Use Alternate Drug. Monitor Closely (1)iron sucrose decreases levels of levothyroxine by inhibition of GI absorption. Use Caution/Monitor. The usual total treatment course of Venofer is 1000 mg. Venofer treatment may be repeated if iron deficiency reoccurs. Where: Medicine concentration Amount of active substance per a given volume of your drug. Pregnancy: Risk Summary-Clinical Considerations. -Hgb deficit (grams) = Hgb deficit (g/dL) x blood volume (dL) -Iron deficit (mg) = Hgb deficit (grams) x 3.3 (mg Fe/g Hgb) [Note: 3.3 x 0.65 = 2.145] This health tool computes the iron deficit based on patient parameters and the Ganzoni formula. Chandler G, Harchowel J, Macdougall I. Applies only to oral form of both agents. Avoid or Use Alternate Drug. The two formulas used are presented below: Iron deficit in mg = Weight in kg x (14 - Hb in g/dL) x 2.145 Volume of product required in mL = Iron deficit in mg / C in mg/mL Where C is the concentration of the iron product: 50 mg/mL for Iron dextran; 20 mg/mL for Iron sucrose; 5 mg/mL for Ferric gluconate. Avoid or Use Alternate Drug. Monitor Closely (1)iron sucrose decreases levels of liothyronine by inhibition of GI absorption. Where C= concentration of elemental iron (mg/ml) in the product being used: Data from Ferrlecit postmarketing spontaneous reports indicate that individual doses exceeding 125 mg may be associated with a higher incidence and/or severity of adverse events, Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD), Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD), WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS, Iron Deficiency and Anemia- signs and therapeutic options. Last updated on Jun 1, 2022. Safety of highdose iron sucrose infusion in hospitalized patients with chronic kidney disease. commonly, these are "preferred" (on formulary) brand drugs. Applies only to oral form of both agents. Applies only to oral form of both agents. Patients diagnosed with iron deficiency are prescribed iron supplementation, either to replete body stores or to correct anemia. Serious - Use Alternative (1)iron sucrose will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Your list will be saved and can be edited at any time. In post-marketing safety studies of Venofer in 1,051 patients with HDD-CKD, adverse reactions reported by >1% were cardiac failure congestive, sepsis and dysgeusia. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. You may need extra iron because of blood loss during kidney dialysis. Minor/Significance Unknown. Both the 200- and 300-mg doses of IV iron sucrose administered over 2 hours appear to be safe. Applies only to oral form of both agents. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Jacobs P, Dommisse J. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Modify Therapy/Monitor Closely. Venofer is indicated for the treatment of iron deficiency anemia (IDA) in patients with chronic kidney disease (CKD). Applies only to oral form of both agents. J Lab Clin Med. Official Journal of the International Society of Nephrology. NOTES: Lab and/or medical tests (such as complete blood count, ferritin, transferrin, total iron binding capacity-TIBC) should be done while you are using this medication. Applies only to oral form of both agents. Divide the calculated dose by the patient's weight (IBW if BMI >30, or actual body weight (ABW) if BMI30) to ensure it does NOT exceed 20mg/kg. Use Caution/Monitor. Applies only to oral form of both agents. Administer Venofer 100 mg undiluted as a slow intravenous injection over 2 to 5 minutes, or as an infusion of 100 mg diluted in a maximum of 100 mL of 0.9% NaCl over a period of at least 15 minutes, per consecutive hemodialysis session. Iron Sucrose - Injection - Alberta When iron sucrose was administered at deliberate overdoses to rabbit dams (up to 215 mg/kg/day) marked fetal/placental iron overload was noted. Your doctor will do laboratory tests to monitor your response. however iron sucrose requires multiple small intermittent doses over days to weeks. Drug Dosing in Obesity Reference Table - ClinCalc.com Applies only to oral form of both agents. Symptoms associated with Venofer total dosage or infusing too rapidly included hypotension, dyspnea, headache, vomiting, nausea, dizziness, joint aches, paresthesia, abdominal and muscle pain, edema and cardiovascular collapse. Max Dose. Below the form there are further instructions on how to use the calculator. Venofer (iron sucrose) 20 mg iron / ml, solution for injection or Either decreases levels of the other by inhibition of GI absorption. Each mL contains 20 mg of elemental iron. For patients weighing less than 50 kg (110 lb): Give Injectafer in two doses separated by at least 7 days. Minor/Significance Unknown. Use Caution/Monitor. This website is intended for use by US healthcare professionals only. Discard unused portion. Venofer may cause clinically significant hypotension. feasible, Maximum total cumulative iron sucrose dose administered in 14 days is 1000 mg elemental iron. Modify Therapy/Monitor Closely. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Avoid or Use Alternate Drug. May increase risk of hypotension. Next Steps Evidence Creator Insights Dr. Andreas M. Ganzoni About the Creator 4. When administered via infusion, dilute up to 750 mg of iron in no more than 250 mL of sterile 0.9% sodium chloride injection, USP, such that the concentration of the infusion is not less than 2 mg of iron per mL and administer over at least 15 minutes. Before using, check this product visually for particles or discoloration. Copyright(c) 2023 First Databank, Inc. vitamin E decreases levels of iron sucrose by increasing hepatic clearance. It varies from increases in dietary intake of iron (usually for prophylaxis purposes) to oral, intramuscular or intravenous therapy. If we don't have the calculator you need we'll try to make it for you and add it to the website. Monitor Closely (1)didanosine will decrease the level or effect of iron sucrose by increasing gastric pH. Ensure the Intravenous Iron Checklist (see trust guideline) has been completed. Applies only to oral form of both agents. 2.1 . Most May increase risk of hypotension. Iron Sucrose [ Venofer ] Elemental iron: 20 mg/mL (2.5 mL, 5 mL, 10 mL) Solution, Intravenous [preservative free]: [package insert] INDICATIONS: Venofer is an iron replacement product indicated for the treatment of iron deficiency anemia in patients with chronic kidney disease (CKD). 1988 May;111(5):566-70. Venofer treatment may be repeated if iron deficiency reoccurs. Applies only to oral form of both agents. Applies only to oral form of both agents. Each mL contains 20 mg of elemental . and formulary information changes. Use Caution/Monitor. DOSAGE AND ADMINISTRATION: Venofer must only be administered intravenously either by slow injection or by infusion. Indications: Ferrlecit is an iron replacement product for treatment of iron deficiency anemia in adult patients and in pediatric patients age 6 years and older with chronic kidney disease receiving hemodialysis who are receiving supplemental epoetin therapy. If hypersensitivity reactions or signs of intolerance occur during administration, stop Venofer immediately. This site contains information for licensed healthcare professionals in the United States. Contact the applicable plan Administer Venofer 100 mg undiluted as a slow intravenous injection over 2 to 5 minutes, or as an infusion of 100 mg diluted in a maximum of 100 mL of 0.9% NaCl over a period of at least 15 minutes, per consecutive hemodialysis session [see How Supplied/Storage and Handling (16.2).] Most Administer Feraheme as an intravenous infusion in 50-200 mL 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP over at least 15 minutes. Formula for calculating the required dose of iron sucrose 1. Parenteral iron supplementation. Applies only to oral form of both agents. Applies only to oral form of both agents. 2000 Jan;22(1):39-43. For iron maintenance treatment, administer Venofer, (2 years of age or older) with NDD-CKD or PDD-CKD who are on erythropoietin therapy for iron maintenance treatment. Iron Injection Administration | INJECTAFER HCP Hemoglobin there are two fields for hemoglobin input, one for the target and another for actual value. Venofer must only be administered intravenously either by slow injection or by infusion. Inspect parenteral drug products visually for the absence of particulate matter and discoloration prior to administration. Pediatric Patients: The most common adverse reactions (2%) are headache, respiratory tract viral infection, peritonitis, vomiting, pyrexia, dizziness, cough, nausea, arteriovenous fistula thrombosis, hypotension and hypertension. The incidence of adverse events with the 400- and 500-mg doses administered as a 2-hour . Applies only to oral form of both agents. Corrected Calcium. Deferasirox chelates iron. Iron Deficiency Calculator - MDApp Nutr Clin Pract. Dosage form: injection, solution 20 mg/mL for Iron sucrose; 5 mg/mL for Ferric gluconate. iron sucrose will decrease the level or effect of sarecycline by inhibition of GI absorption. Use Caution/Monitor. Iron Sucrose Protocol - Cmqcc Parenteral iron dextran therapy: a review. The above information is provided for general VenAccess is a trademark of Vifor (International) Inc. Switzerland. Deferoxamine chelates iron. Applies only to oral form of both agents. You are encouraged to report Adverse Drug Events to American Regent, Inc. at 1-800-734-9236 or to the FDA by visiting www.fda.gov/medwatch or calling 1-800-FDA-1088. Monitor Closely (1)iron sucrose will decrease the level or effect of sarecycline by inhibition of GI absorption. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product that meets the needs of the patient. Anemia; 2015: 763576. Applies only to oral form of both agents. Maximum recommended single dose: 300 mg (See Prescriber's Orders). Use Caution/Monitor. Iron sucrose can also be mixed in a saline solution and given through an IV over a longer time.Your dosage and length of treatment are based on your medical condition, age, and response to treatment. Multiple placebo-controlled, randomized clinical trials have been conducted with IV iron in patients with New York Heart Association class II-III heart failure with an ejection fraction 45% who met criteria . Estimates the iron deficit in preparation for iron replacement based on patient weight and haemoglobin. Slowing the infusion rate may alleviate symptoms. Taking the case of a patient weighing 75 kg (165.3 lbs) with a target hemoglobin value of 13 g/dL (130 g/L or 8.07 mmol/L), an actual hemoglobin of 9.5 g/dL (95 g/L or 5.9 mmol/L) and iron stores of 500 mg, the iron deficit is: Iron deficit = 75 x (13 9.5) x 2.4 + 500 = 1,130 mg. Applies only to oral form of both agents. Applies only to oral form of both agents. 10th ed. Hypotension following administration of Venofer may be related to rate of administration and/or total dose delivered. The dosing for iron replacement treatment in pediatric patients with hemodialysis-dependent chronic kidney disease (HDD-CKD), non-dialysis-dependent chronic kidney disease (NDD-CKD) or peritoneal-dialysis-dependent chronic kidney disease (PDD-CKD) has not been established. Applies only to oral form of both agents. There are four fields that need to be completed: Weight body weight is used to establish iron deficit and is also taken into account when estimating the iron stores. Venofer is given as an infusion into a vein. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Patients may present with shock, clinically significant hypotension, loss of consciousness and/or collapse. Minor/Significance Unknown.iron sucrose increases levels of calcium acetate by enhancing GI absorption. Koch TA, Myers J, Goodnough LT. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. . Monitor Closely (1)omeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Avoid or Use Alternate Drug. Parenteral Iron Replacement For Anemia Calculator - MDApp Minor/Significance Unknown. Monitor Closely (1)deferasirox decreases levels of iron sucrose by inhibition of GI absorption. Administer Venofer in 3 divided doses, given by slow intravenous infusion, within a 28 day period: 2 infusions each of 300 mg over 1.5 hours 14 days apart followed by one 400 mg infusion over 2.5 hours 14 days later. Venofer has not been studied in patients younger than 2 years old. Ganzoni Equation for Iron Deficiency Anemia - MDCalc Have resuscitation equipment and personnel trained in the detection and treatment of anaphylactic-type reactions readily available during INFeD administration. Feraheme does not contain antimicrobial preservatives. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: vitamin products, other iron-containing products. Applies only to oral form of both agents. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Serum iron, total iron binding capacity (TIBC) and percent saturation of transferrin are other important tests for detecting and monitoring the iron deficient state. Fulminant symptoms include confusion, sensation of passing out, paleness. Case G. Maintaining iron balance with total-dose infusion of intravenous iron dextran. Intermediate calculations: -Blood volume (dL) = [65 (mL/kg) x body weight (kg)] / 100 (mL/dL) -Hgb deficit (g/dL) = 14.0 - patient hgb conc. Avoid or Use Alternate Drug. Minor (1)iron sucrose, captopril. )If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Anemia; 2015: 763576. Monitor Closely (1)vonoprazan will decrease the level or effect of iron sucrose by inhibition of GI absorption. The weight of the patient is taken into account in order to estimate iron stores, while haemoglobin is required as both current measured and target. 2010;18(3). Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Always ask your health care professional for complete information about this product and your specific health needs. These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations. Use Caution/Monitor. We comply with the HONcode standard for trustworthy health information. Applies only to oral form of both agents. Administer Venofer 200 mg undiluted as a slow intravenous injection over 2 to 5 minutes or as an infusion of 200 mg in a maximum of 100 mL of 0.9% NaCl over a period of 15 minutes. Use Caution/Monitor. iron sucrose decreases levels of mycophenolate by inhibition of GI absorption. lansoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. (1970) Intravenous iron-dextran: therapeutic and experimental possibilities. Each mL contains 20 mg of elemental iron. ]Venofer treatment may be repeated if iron deficiency reoccurs. A target haemoglobin value is also input so iron deficit can be determined according to a specified individual target. Applies only to oral form of both agents. Mode of Administration: Administer Venofer only intravenously by slow injection or by infusion. iron sucrose will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects.
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