Expected Ferritin Increase from 200 mg Venofer
A single 200 mg infusion of Venofer (iron sucrose) typically increases serum ferritin by approximately 200-270 ng/mL when measured 4-8 weeks post-infusion.
Evidence from Clinical Trials
The FDA-approved Venofer label provides the most direct evidence for this question. In Study B, which evaluated 23 hemodialysis patients receiving iron sucrose, the mean serum ferritin increased by 266.3 ± 30.3 ng/mL from baseline to end of treatment 1. This study specifically used dosing regimens that included 200 mg infusions.
In Study A, which administered 100 mg doses over 10 consecutive dialysis sessions (total 1000 mg), the ferritin increase was 165.3 ± 24.2 ng/mL 1. This translates to roughly 165 ng/mL per 1000 mg, or approximately 33 ng/mL per 100 mg dose - though this calculation is imprecise given the cumulative dosing schedule.
Supporting Research Data
Additional research studies corroborate these findings:
A 2005 study in CKD patients showed that 5 weekly doses of 200 mg iron sucrose (total 1000 mg) increased mean ferritin by 288 ng/mL 2, suggesting approximately 58 ng/mL per 200 mg dose when given as part of a series.
A 2025 study in female patients with iron deficiency anemia demonstrated ferritin increased from 10.2 ng/dL to 224.12 ng/dL after one month of treatment with 200 mg twice weekly 3.
A 2008 peritoneal dialysis study using 200 mg weekly for 4 weeks showed significant ferritin increases that were maintained with subsequent dosing 4.
Important Clinical Caveats
Do not check ferritin levels within 4 weeks of IV iron administration - the circulating iron interferes with the assay, leading to spuriously elevated results 5. The optimal timing for laboratory evaluation is 4-8 weeks after the last infusion.
Inflammation significantly affects ferritin interpretation. Ferritin is an acute phase reactant, and its rise is blunted during inflammatory states even when absolute iron deficiency is present 5. In patients with inflammation, transferrin saturation (TSAT) <20% is more reliable for diagnosing iron deficiency than ferritin alone.
Practical Application
For a patient receiving a single 200 mg Venofer infusion:
- Expected ferritin rise: 200-270 ng/mL when measured at 4-8 weeks
- The response varies based on baseline iron stores, ongoing losses, and inflammatory status
- Hemoglobin should increase by 1-2 g/dL within 4-8 weeks if iron deficiency was the primary cause of anemia 5
- Goal ferritin in the absence of inflammation is ≥50 ng/mL 5
The actual increase may be lower if there are ongoing blood losses or conditions impairing iron absorption, requiring repeat dosing at intervals determined by the underlying etiology 5.