What is the frequency of administration for Venofer (iron sucrose)?

From the Guidelines

Venofer (iron sucrose) can be administered with a maximum single dose of 200 mg and a maximum weekly dose of 500 mg, with a minimum infusion time of 30 minutes for the maximum dose, as recommended by the European Medicines Agency (EMA) 1. The frequency of Venofer administration depends on the patient's condition and treatment protocol.

• For adults with iron deficiency anemia, a typical regimen is 200 mg given by slow IV injection or infusion 1-3 times weekly until the total calculated dose is reached.
• For hemodialysis-dependent chronic kidney disease patients, the usual dosing is 100 mg during each dialysis session, typically three times weekly.
• For non-dialysis dependent chronic kidney disease patients, 200 mg can be given once every 2 weeks for a total of 5 doses. The maximum single dose should not exceed 200 mg for non-dialysis patients or 100 mg for hemodialysis patients. The frequency should be adjusted based on hemoglobin levels, transferrin saturation, and ferritin levels, with monitoring every 1-3 months in patients receiving iron and/or ESA therapy 1. Adequate spacing between doses is important to allow the body to process the iron and minimize adverse reactions. Venofer administration should be monitored carefully as rapid infusion can cause hypotension and other adverse effects. The treatment course typically continues until iron stores are replenished, as indicated by laboratory parameters reaching target levels. It is essential to note that the treatment protocol may vary depending on the patient's response to therapy and the presence of any adverse effects, and should be guided by the most recent and highest-quality evidence, such as the 2021 study published in Kidney International 1.

From the FDA Drug Label

2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion.

1. 1 Mode of Administration Administer Venofer only intravenously by slow injection or by infusion.
2. 2 Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD) 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
3. 3 Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD) 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. Administer on 5 different occasions over a 14 day period.
4. 4 Adult Patients with Peritoneal Dialysis Dependent-Chronic Kidney Disease (PDD-CKD) 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. 2.5 Pediatric Patients (2 Years of Age and Older) with HDD-CKD for Iron Maintenance Treatment 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
5. 6 Pediatric Patients (2 Years of Age and Older) with NDD-CKD or PDD-CKD who are on Erythropoietin Therapy for Iron Maintenance Treatment For iron maintenance treatment: Administer Venofer at a dose of 0.5 mg/kg, not to exceed 100 mg per dose, every four weeks for 12 weeks

The frequency of Venofer administration varies depending on the patient population:

• Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD): 100 mg per consecutive hemodialysis session.
• Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD): 200 mg on 5 different occasions over a 14 day period.
• Adult Patients with Peritoneal Dialysis Dependent-Chronic Kidney Disease (PDD-CKD): 3 divided doses within a 28 day period.
• Pediatric Patients (2 Years of Age and Older) with HDD-CKD: 0.5 mg/kg every two weeks for 12 weeks.
• Pediatric Patients (2 Years of Age and Older) with NDD-CKD or PDD-CKD: 0.5 mg/kg every four weeks for 12 weeks 2.

From the Research

Frequency of Venofer Administration

The frequency of Venofer (iron sucrose) administration can vary depending on the patient's condition and response to treatment.

• According to a study published in 2001 3, iron sucrose was administered in 10 doses, each administered undiluted as 100 mg IV push over 5 minutes, without a prior test dose.
• A study published in 2011 4 administered a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.
• Another study published in 2008 5 administered 200 mg of intravenous iron weekly until ferritin levels exceeded 500 ng/ml, followed by 200 mg monthly thereafter.
• A review published in 2020 6 summarized the evidence accumulated during 70 years of clinical experience with iron sucrose, but did not specify a particular administration frequency.
• A review published in 2025 7 indicated that intravenous iron is typically administered as needed, based on the patient's iron deficiency status and response to treatment.

Factors Influencing Administration Frequency

The frequency of Venofer administration may be influenced by several factors, including:

• Patient's iron deficiency status and response to treatment
• Presence of underlying medical conditions, such as chronic kidney disease or heart failure
• Patient's tolerance to oral iron therapy
• Severity of anemia or iron deficiency
• Presence of inflammatory conditions, such as inflammatory bowel disease or cancer

Safety and Efficacy

The safety and efficacy of Venofer administration have been established in several studies, including those published in 2001 3, 2008 5, and 2011 4.

• These studies demonstrated significant improvements in hemoglobin, ferritin, and transferrin saturation levels, as well as exercise tolerance and symptoms, with minimal adverse events.
• A review published in 2020 6 summarized the evidence accumulated during 70 years of clinical experience with iron sucrose, highlighting its acceptable safety profile and efficacy in treating iron deficiency and iron-deficiency anemia.