What is the dosing for Venofer (iron sucrose)?

From the Guidelines

Venofer should be dosed at a maximum single dose of 200 mg, with a maximum weekly dose of 500 mg, and administered over at least 15 minutes for doses up to 100 mg, or 30 minutes for the maximum dose, as recommended by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) 1. The dosing regimen for Venofer (iron sucrose) can vary depending on the patient's condition and the calculated iron deficit.

• For most adults, a common regimen is 200 mg administered 1-3 times weekly until the total calculated iron deficit is reached.
• The total iron requirement can be calculated using the Ganzoni formula based on the patient's weight, hemoglobin level, and target hemoglobin.
• For hemodialysis patients, a maintenance regimen of 100 mg 1-3 times weekly is often used. Key considerations for Venofer administration include:
• Administration as a slow IV push at 1 mL/minute (20 mg/min) or as an infusion diluted in 100 mL normal saline.
• Monitoring for hypersensitivity reactions during and after administration, particularly with the first dose, as recommended by the EMA and FDA 1. Venofer is generally better tolerated than other IV iron formulations, with lower rates of anaphylactic reactions, making it suitable for patients who cannot tolerate oral iron due to side effects or who need rapid iron repletion, as noted in the study published in Kidney International 1.

From the FDA Drug Label

2.2 Dosage

The dosage of Venofer is expressed in mg of elemental iron. Each mL contains 20 mg of elemental iron.

• Dosing: The recommended dosage is 100 mg of elemental iron per dose, administered as an undiluted intravenous injection over 2 to 5 minutes, or as an infusion of up to 500 mg of elemental iron per dose, administered over a period of at least 15 minutes, with a maximum of 1000 mg per week 2.
• Administration: Venofer should only be administered intravenously by healthcare professionals.
• Frequency: The frequency of administration is determined by the patient's individual needs and response to treatment.

From the Research

Venofer Dosing

• Venofer, also known as iron sucrose, is a nanomedicine used to treat iron deficiency and iron-deficiency anemia 3.
• The dosing of Venofer is not explicitly stated in the provided studies, but it is mentioned that intravenous iron administration, including Venofer, is recommended for patients who are unable to take or do not respond to oral iron therapy 3, 4.
• In certain conditions, such as end-stage kidney disease, chronic heart failure, and inflammatory bowel disease, intravenous iron administration has become first-line treatment 3.
• The safety profile of Venofer is considered acceptable, with a lower risk of serious life-threatening anaphylaxis compared to iron dextran 5.
• A study reported that a patient with a previous hypersensitivity reaction to ferric gluconate was able to safely receive iron sucrose, implying that it may be possible to administer Venofer to patients with hypersensitivity to other intravenous iron products 6.
• Another study found that sodium ferric gluconate complex in sucrose, a similar intravenous iron product, was well-tolerated and effective in treating iron deficiency anemia in adults 7.