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4. The following table present normal hemoglobin ranges: There is another equation for iron deficit that can be used to calculate replenishment needs, that of Ganzoni, which takes into account iron stores as well and that can be found in the iron deficit calculator. This drug is available at the lowest co-pay. SIDE EFFECTS: Muscle cramps, nausea, vomiting, strange taste in the mouth, diarrhea, constipation, headache, cough, back pain, joint pain, dizziness, or swelling of the arms/legs may occur. 2. FOR PATIENTS WEIGHING LESS THAN 50 kg: Administer Monoferric as 20 mg/kg actual body weight by intravenous infusion 20 minutes . 1982;13(4):309-21. Fatal reactions have followed the test dose of iron dextran injection. 1. 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).] Maintain a well-balanced diet, and follow any dietary guidelines as directed by your doctor. Ferritin and transferrin are also recommended monitoring . Only administer Venofer when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. The incidence of adverse events with the 400- and 500-mg doses administered as a 2-hour . Use Caution/Monitor. with NDD-CKD or PDD-CKD who are on erythropoietin therapy for iron maintenance treatment, Hemodialysis-dependent chronic kidney disease (HDD-CKD)*, Non-dialysis-dependent chronic kidney disease (NDD-CKD), Peritoneal-dialysis-dependent chronic kidney disease (PDD-CKD), At a dose of 0.5 mg/kg, not to exceed 100 mg per dose, Given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at concentrations of 1 to 2 mg/mL and administered over 5 to 60 minutes, An increase in Hb concentration or a decrease in ESA dose is desired and. 1990 Feb;24(2):162-6. Either increases effects of the other by pharmacodynamic synergism. Ferric gluconate: 12.5 mg/mL Schrier SL, Mentzer WC, Landaw SA. IDA diagnosis is based on full blood examination and on the serum ferritin level. Intermediate calculations: -Blood volume (dL) = [65 (mL/kg) x body weight (kg)] / 100 (mL/dL) -Hgb deficit (g/dL) = 14.0 - patient hgb conc. omeprazole will decrease the level or effect of iron sucrose by increasing gastric pH. DOSAGE AND ADMINISTRATION: The recommended dose of Feraheme is an initial 510 mg dose followed by a second 510 mg dose 3 to 8 days later. Iron deficit - equation derivation: Assumptions: -Blood volume = 65 mL/kg -Hemoglobin conc target =14.0 g/dL -Deficits in body stores are ignored. Minor/Significance Unknown. Monitor Closely (1)iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. Do Not Copy, Distribute or otherwise Disseminate without express permission. Comparable efficacy to that of IV iron sucrose. Iron stores 500 mg for body weight greater than or equal to 35 kg (77 lbs) and 15 mg/kg for body weight less than 35 kg. Creating an account is free and takes less than 1 minute. Administer while the patient is in a reclined or semi-reclined position. Situation Analysis Market Size MAT Sales Cr LC MAT Share % MAT Gr % Total Pharma Market 9388.69 100 13.5 Iron Sucrose 11.18 93.81 37.65 Brand Company Saline MAT . These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. Controlled studies in pregnant women show no evidence of fetal risk. Corrected Sodium and Effective Osmolality. Each costs about $0.46 to $0.55 per mg of iron. This information is not individual medical advice and does not substitute for the advice of your health care professional. Modify Therapy/Monitor Closely. Mode of Administration: Administer Venofer only intravenously by slow injection or by infusion. Nutr Clin Pract. The recommendation is that most adults need a cumulative dose of elemental iron of at least 1 g. Iron replenishment can be done intravenously, either as total dose (example: iron-dextran or iron carboxymaltose) or as split dose (example: iron sucrose). Applies only to oral form of both agents. Copyright 2021 GlobalRPH - Web Development by. The dosing for iron replacement treatment in pediatric patients with HDD-CKD has not been established. Applies only to oral form of both agents. Use Caution/Monitor. Ren Fail. Do not mix iron sucrose with other medications or TPN solution. Fulminant symptoms include confusion, sensation of passing out, paleness. Formula for calculating the required dose of iron sucrose 1. Minor/Significance Unknown.iron sucrose increases levels of calcium chloride by enhancing GI absorption. Minor/Significance Unknown. Corrected Calcium. The Ganzoni equation is: Total iron deficit (mg) = Weight in kg x (Target Hb - Actual Hb in g/dL) x 2.4 + Iron stores In most cases, adult patients require a cumulative dose of elemental iron of at least 1 g. Most commonly, iron replenishment therapy is done intravenously: As total dose (iron-dextran or iron - carboxymaltose); Modify Therapy/Monitor Closely. Although anaphylactic reactions known to occur following INFeD administration are usually evident within a few minutes, or sooner, it is recommended that a period of an hour or longer elapse before the remainder of the initial therapeutic dose is given. Untreated IDA in pregnancy is associated with adverse maternal outcomes such as post-partum anemia. Give each dose as 750 mg for a total cumulative dose of 1500 mg of iron per course. Deferasirox chelates iron. Serious - Use Alternative (1)iron sucrose decreases levels of mycophenolate by inhibition of GI absorption. Venofer must only be administered intravenously either by slow injection or by infusion. Applies only to oral form of both agents. Dosage form: injection, solution Included in the iron dextran package insert. 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. Applies only to oral form of both agents. iron sucrose decreases levels of oxytetracycline by inhibition of GI absorption. All Rights Reserved. Venofer treatment may be repeated if iron deficiency reoccurs. 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. Each mL contains 20 mg of elemental iron. Estimates the iron deficit in preparation for iron replacement based on patient weight and haemoglobin. Slowing the infusion rate may alleviate symptoms. Recommended dosing and infusion rates for PI. Hollands J, Foote E, Rodriguez A. Use Caution/Monitor. WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS Fatal and serious hypersensitivity reactions including anaphylaxis have occurred in patients receiving Feraheme. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 1998 Feb;25(1):65-8. Parenteral iron supplementation. All Rights Reserved. Calculates iron deficit for dosing iron. The dosage of Venofer is expressed in mg of elemental iron. Medscape Education, Improving Quality of Care in Patients With Iron Deficiency Anemia and Inflammatory Bowel Disease, 2010feosol-carbonyl-fe-icar-c-carbonyl-iron-342171Drugs, encoded search term (iron sucrose (Venofer)) and iron sucrose (Venofer), Use of High-Dose Iron in Dialysis in US Tracks PIVOTAL Trial, FDA Watch List Adds Drugs With Anaphylaxis, Herpes, Fetal Death Risk, Dialysis Industry Mergers: Profits Rise as Patient Outcomes Worsen, Hematology-Oncology Guidelines: 2017 Midyear Review. Applies only to oral form of both agents. Congenital Pulmonary Airway Malformation Volume Ratio (CVR) Calculator -. Serious - Use Alternative (1)iron sucrose decreases levels of demeclocycline by inhibition of GI absorption. Most Avoid or Use Alternate Drug. Recommended dosage for patients weighing less than 50kg (110lb): Give Injectafer in This site complies with the HONcode standard for trust- worthy health information: verify here. Avoid or Use Alternate Drug. Contraindicated. Sodium ferric gluconate complex injection [ Ferrlecit ] [package insert] - Elemental iron: 12.5 mg/mL (5 mL). 2010;18(3). Monitor Closely (1)iron sucrose decreases levels of ibandronate by inhibition of GI absorption. Use Caution/Monitor. didanosine will decrease the level or effect of iron sucrose by increasing gastric pH. Avoid or Use Alternate Drug. David McAuley, Pharm.D. Pregnancy: Risk Summary-Clinical Considerations. restrictions. Monitor Closely (1)vitamin E decreases levels of iron sucrose by increasing hepatic clearance. Applies only to oral form of both agents. Copyright 2021 GlobalRPH - Web Development by, Calculation of the Total Iron Deficit Alternative equation. Applies only to oral form of both agents. Calculation of Dosage of Nefrofer Total Iron Deficit (mg) Nefrofer (ml) = 20mg/ml Total Iron Deficit (mg) = Body weight (kg) x (Target Hb - Actual Hb) [g/l] x 0.24* + Depot Iron . For males: LBW = 50 kg + 2.3 kg for each inch of patients height over 5 feet For females: LBW = 45.5 kg + 2.3 kg for each inch of patients height over 5 feet. iron sucrose decreases levels of tetracycline by inhibition of GI absorption. Either increases effects of the other by pharmacodynamic synergism. Venofer and the Venofer logo are registered trademarks of Vifor (International) Inc., Switzerland. Monitor patients for signs and symptoms of hypersensitivity during and after Venofer administration for at least 30 minutes and until clinically stable following completion of the infusion. 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. Avoid or Use Alternate Drug. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Always ask your health care professional for complete information about this product and your specific health needs. Applies only to oral form of both agents. In most cases, adult patients require a cumulative dose of elemental iron of at least 1 g. Most commonly, iron replenishment therapy is done intravenously: As total dose (iron-dextran or iron carboxymaltose); Iron deficiency is common during childhood growth, prolonged periods of sickness, in convalescence or during pregnancy. Due Date form Ultrasound Report. IDA symptoms vary, may not be specific and include tiredness, weakness, shortness of breath. In case a pediatric patient with a weight below 35 kg is assessed, iron stores are calculated as 15 mg iron for each kg. 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. Use Caution/Monitor. Applies only to oral form of both agents. Applies only to oral form of both agents. Monitor Closely (1)lansoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. 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. Adding plans allows you to compare formulary status to other drugs in the same class. Applies only to oral form of both agents. View the formulary and any restrictions for each plan. Minor/Significance Unknown. Evaluate the hematologic response (hemoglobin, ferritin, iron and transferrin saturation) at least one month following the second Feraheme infusion. There is limited experience with administration of an infusion of 500 mg of Venofer, diluted in a maximum of 250 mL of 0.9% NaCl, over a period of 3.5 to 4 hours on Day 1 and Day 14. Applies only to oral form of both agents. Use Caution/Monitor. Treatment of anemia due to iron deficiency. A: Generally acceptable. For repletion treatment most patients may require a cumulative dose of 1000 mg of elemental iron administered over 8 dialysis sessions. There is limited experience with administration of an infusion of 500 mg of Venofer, diluted in a maximum of 250 mL of 0.9% NaCl, over a period of 3.5 to 4 hours on Day 1 and Day 14 [see How Supplied/Storage and Handling (16.2). Your dosage and length of treatment are based on your medical condition, age, and response to treatment. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. The usual total treatment course of Venofer is 1000 mg. Venofer treatment may be repeated if iron deficiency reoccurs. 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. Separate dosing of tetracyclines from these products. Manufacturer advises for slow intravenous injection ( Venofer ), give undiluted at a rate of 1 mL/minute; do not exceed 10 mL (200 mg iron) per injection. Feraheme does not contain antimicrobial preservatives. Applies only to oral form of both agents. Administer Venofer early during the dialysis session (generally within the first hour). Next Steps Evidence Creator Insights Dr. Andreas M. Ganzoni About the Creator Applies only to oral form of both agents. Minor/Significance Unknown. Use Caution/Monitor. Applies only to oral form of both agents. Intravenous iron-dextran: therapeutic and experimental possibilities [in German] Schweiz Med Wochenschr. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Applies only to oral form of both agents. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. Ferumoxytol [ Feraheme ] Elemental iron: 510 mg/17 mL (17 mL) 30 mg/mL [package insert] - Boxed warning REVIEW INSERT. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration. Am J Hosp Pharm. Applies only to oral form of both agents. calcium carbonate decreases levels of iron sucrose by inhibition of GI absorption. Serum iron, total iron binding capacity (TIBC) and percent saturation of transferrin are other important tests for detecting and monitoring the iron deficient state. Modify Therapy/Monitor Closely. David McAuley, Pharm.D. Since this is less than the threshold of total dose of 20 mg/kg, the deficit can be eliminated with a single infusion. Observed Hb = the patients current hemoglobin in g/dl. Applies only to oral form of both agents. iron sucrose increases levels of calcium chloride by enhancing GI absorption. iron sucrose, captopril. This website also contains material copyrighted by 3rd parties. All adult and pediatric patients receiving Venofer require periodic monitoring of hematologic and iron parameters (hemoglobin, hematocrit, serum ferritin and transferrin saturation). Either increases effects of the other by pharmacodynamic synergism. Applies only to oral form of both agents. Ferrlecit may also be administered undiluted as a slow intravenous injection (at a rate of up to 12.5 mg/min) per dialysis session. Venofer may reduce the absorption of concomitantly administered oral iron preparations. Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to INFeD. Hemoglobin iron deficit = 60 x (14 - 8) x (2.145) = 772 mg iron. 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. For iron maintenance treatment: Administer Venofer at a dose of 0.5 mg/kg, not to exceed 100 mg per dose, every two weeks for 12 weeks given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at a concentration of 1 to 2 mg/mL and administered over 5 to 60 minutes. 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. Please confirm that you would like to log out of Medscape. The normal ranges are: for males 13.8 to 18.0 g/dL (138 to 180 g/L, or 8.56 to 11.17mmol/L) and for females 12.1 to 15.1 g/dL (121 to 151 g/L, or 7.51 to 9.37mmol/L). 2 *Venofer is an iron replacement product indicated for the treatment of iron deficiency anemia in patients with CKD. . (3) Known hypersensitivity to Venofer. Minor/Significance Unknown. Serious - Use Alternative (1)iron sucrose decreases levels of minocycline by inhibition of GI absorption. Oral and parenteral products - see background option for oral products. Transferrin saturation (TSAT) values increase rapidly after intravenous administration of iron sucrose; do not perform serum iron measurements for at least 48 hours after intravenous dosing. Applies only to oral form of both agents. Can't find what you need? Keep all medical and lab appointments. Monitor Closely (1)pantoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Am J Kid Dis 2001; 38 988991. Avoid or Use Alternate Drug. Applies only to oral form of both agents. pantoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Initial symptoms may include hypotension, syncope, unresponsiveness, cardiac/cardiorespiratory arrest. Applies only to oral form of both agents. iron sucrose decreases levels of penicillamine by inhibition of GI absorption. Fill in the calculator/tool with your values and/or your answer choices and press Calculate. The cost of Venofer is $145 for a dose of 300 mg and Monoferric is $274 for a dose of 500mg. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Monitor Closely (1)sodium citrate/citric acid will decrease the level or effect of iron sucrose by increasing gastric pH. Human studies not conducted. Chandler G, Harchowel J, Macdougall I. Applies only to oral form of both agents. UpToDate. Applies only to oral form of both agents. Applies only to oral form of both agents. Monitor Closely (1)famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. Modify Therapy/Monitor Closely. Venofer [package insert]. Do not dilute to concentrations below 1 mg/mL [see How Supplied/Storage and Handling (16.2).] Echocardiogram Z Score (NEW)(BETA TESTING) Edinburgh Postnatal Depression Scale. Separate by 2 hr. Iron supplements, regardless of their way of administration, are used to replete body stores and to correct anemia. Our dosage calculator can help you with this as well. 2 Protocol for Intravenous iron sucrose - Venofer 2.1 Dosage The total cumulative dose of Venofer should be calculated using the table below. Minor (2)calcium gluconate decreases levels of iron sucrose by inhibition of GI absorption. Total cumulative Venofer dose = number of 100mg ampoules for Hb increase. J Lab Clin Med. 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: 20 mg/mL. Minor/Significance Unknown. Iron deficiency anemia calculator (diagnosis), Iron deficiency anemia vs. If either is present, do not use the liquid. 1 ,*. The original formula employs the weight in kg but users can input it in lbs and it gets transformed. Applies only to oral form of both agents. PRECAUTIONS: Before using iron sucrose, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Auerbach M, Witt D, Toler W, Fierstein M, Lerner RG, Ballard H. Clinical use of the total dose intravenous infusion of iron dextran. 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. Available for Android and iOS devices. 2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion. Minor/Significance Unknown. Parenteral iron product is iron sucrose (C = 20 mg elemental iron/mL). Serious - Use Alternative (1)iron sucrose decreases levels of moxifloxacin by inhibition of GI absorption. iron sucrose decreases levels of levothyroxine by inhibition of GI absorption. A patients lean body weight (or actual body weight if less than lean body weight) should be utilized when determining dosage. 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 . Separate by 2 hr. Other indications for IV are pregnancy iron deficiency, chronic renal impairment or need for rapid repletion. MDCalc loves calculator creators researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. Philadelphia, PA: Lippincott Williams & Wilkins;2013;303-307. Schweiz Med Wochenschr; 100(7):301-3. If we don't have the calculator you need then tell us the details and we'll make it for you. vitamin E decreases levels of iron sucrose by increasing hepatic clearance. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. provider for the most current information. If you have private insurance, Venofer or Monoferric may be on the list of covered medications. cimetidine will decrease the level or effect of iron sucrose by increasing gastric pH. Avoid or Use Alternate Drug. iron sucrose decreases levels of methyldopa by inhibition of GI absorption. Either increases effects of the other by pharmacodynamic synergism. Applies only to oral form of both agents. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. 2022 American Regent, Inc.PP-VE-US-0016 (v6.0)1/2022. Drug class: Iron products. Iron metabolism needs to be balanced and bleeding, the major cause of iron deficiency (for instance in menstruation in females and chronic occult gastrointestinal bleeding) needs to be addressed. It is usually given slowly over 2 to 5 minutes or as directed by your doctor. . J Med. Introduction Uses Dosage Warnings Interactions Stability Introduction Hematinic agent; a polynuclear iron (III)-hydroxide sucrose complex. Pediatric Patients (2 Years of Age and Older). Each mL contains 20 mg of elemental iron. USES: This medicine is used to treat "iron-poor" blood (anemia) in people with long-term kidney disease. Mean Corpuscular Hemoglobin Concentration (MCHC) Calculator, Red Blood Cell (RBC) Indices Calculator, Iron Deficiency In Pregnancy Calculator.