From the Guidelines
Ferrlecit (sodium ferric gluconate) should be administered at a maximum single dose of 125 mg, with a minimum infusion time of 60 min, as recommended by the FDA 1. The dosing schedule for Ferrlecit is crucial in managing iron deficiency anemia in patients with chronic kidney disease (CKD).
- The maximum single dose of 125 mg should not be exceeded, and the minimum infusion time of 60 min should be adhered to, to minimize the risk of adverse reactions.
- The maximum weekly dose is not stated, but it is essential to monitor ferritin and transferrin saturation levels during therapy to avoid iron overload.
- Ferrlecit can be administered to patients on dialysis, with a typical dose of 125 mg per dialysis session, given over 1 hour.
- For patients not on dialysis, the same dose can be given 1-3 times weekly, depending on the individual's iron needs and response to treatment.
- It is crucial to administer Ferrlecit in a setting where anaphylaxis can be treated, as hypersensitivity reactions can occur, particularly with the first dose, as reported in the study published in Kidney International 1.
From the Research
Ferrlecit Schedule
The schedule for Ferrlecit, also known as sodium ferric gluconate complex in sucrose, can vary depending on the patient's condition and the dose administered.
- The typical dose of Ferrlecit is 62.5-125 mg per treatment, which is suitable for hemodialysis patients 2.
- In some cases, higher doses of Ferrlecit, such as 250-500 mg, have been used, but these doses are associated with a higher risk of side effects, including nausea, vomiting, and hypotension 3.
- The frequency of Ferrlecit administration can also vary, with some patients receiving treatment on consecutive dialysis days, while others may receive treatment on a less frequent schedule 2, 4.
Administration Guidelines
The administration of Ferrlecit should be guided by the patient's individual needs and medical condition.
- Patients with chronic kidney disease may require more frequent or higher doses of Ferrlecit to manage their anemia 5.
- Patients with a history of adverse reactions to iron dextran may be able to tolerate Ferrlecit without adverse effects 4.
- The safety and efficacy of Ferrlecit have been demonstrated in various patient populations, including those with chronic kidney disease and hemodialysis patients 2, 5.
Dosing Strategies
Different dosing strategies have been employed in various studies, including:
- High-dose Ferrlecit, where the single dose is calculated based on the patient's iron deficit 4.
- Standard dosing, where Ferrlecit is administered at a dose of 62.5-125 mg per treatment 2, 5.
- The choice of dosing strategy may depend on the patient's individual needs and medical condition, as well as the clinician's preference 4, 5.