How to Order Ferric Gluconate IV 125mg Infusion
Order ferric gluconate (Ferrlecit) 125 mg diluted in 100 mL of 0.9% sodium chloride, infused intravenously over 1 hour. 1
Standard Adult Dosing Protocol
The FDA-approved administration for ferric gluconate 125 mg offers two options 1:
- Diluted infusion (preferred): 125 mg (10 mL) diluted in 100 mL of 0.9% normal saline, infused over 1 hour
- Undiluted slow IV push: Administered undiluted at a rate up to 12.5 mg/min (approximately 10 minutes for full dose)
Key Ordering Details
Do not mix ferric gluconate with other medications or add to parenteral nutrition solutions 1. The medication must be administered in 0.9% saline only.
Typical Order Format:
- Medication: Ferric gluconate (Ferrlecit) 125 mg
- Diluent: 100 mL 0.9% sodium chloride
- Rate: Infuse over 60 minutes
- Frequency: Per dialysis session (for hemodialysis patients) or as prescribed for other indications
Important Safety Considerations
Individual doses exceeding 125 mg may be associated with higher incidence and/or severity of adverse events 1. While research shows that 250 mg doses can be safely administered 2, 3, the FDA label specifically warns about this, and the standard approved dose remains 125 mg per session.
Infusion Rate Matters
Pharmacokinetic studies demonstrate that peak drug levels (Cmax) vary significantly by infusion rate 1. The 1-hour infusion provides a safer profile compared to rapid administration, though both are FDA-approved options.
Monitoring Requirements
Observe patients during and after infusion for acute onset of minor infusion reactions 4. The product contains 9 mg/mL of benzyl alcohol 1, which should be considered in susceptible populations.
Pediatric Dosing (if applicable)
For pediatric patients: 0.12 mL/kg (1.5 mg/kg elemental iron), maximum 125 mg, diluted in 25 mL of 0.9% sodium chloride, infused over 1 hour 1.
Clinical Context
Ferric gluconate has rapid clearance with a terminal elimination half-life of approximately 1-1.5 hours 1. Approximately 80% of drug-bound iron is delivered to transferrin within 24 hours 1, 5. This makes it suitable for frequent dosing in hemodialysis patients, typically administered during each dialysis session.
The medication is not dialyzable (less than 1% removed through dialysis membranes) 1, so timing relative to dialysis is not critical for drug retention.