Can Venofer (iron sucrose) be administered daily?

From the Guidelines

Venofer (iron sucrose) should not be administered daily as a standard approach, but rather 1-3 times weekly, with a maximum weekly dose of 500 mg, as recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) conference 1. The typical administration schedule for Venofer is 100-200 mg per dose, given 1-3 times weekly until the total calculated iron deficit is reached.

• The maximum single dose of Venofer is 200 mg, with a minimum infusion time of 30 minutes for the maximum dose, as approved by the European Medicines Agency (EMA) 1.
• The minimum injection time for the maximum dose is 10 minutes, as approved by the EMA 1.
• Daily administration of Venofer may be considered in specific clinical situations, such as hospitalized patients requiring rapid iron repletion or those with severe iron deficiency anemia, but this approach increases the risk of adverse reactions.
• Patients receiving Venofer should be closely monitored for adverse reactions, especially during the first dose, and healthcare providers should ensure adequate hydration before administration and have emergency medications available to treat potential hypersensitivity reactions.
• The decision for daily administration should be based on the severity of iron deficiency, the patient's clinical condition, and the need for rapid iron repletion, taking into account the potential risks and benefits, as well as the recommendations from the KDIGO conference 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.

The recommended administration schedules for Venofer do not support daily administration.

• For HDD-CKD patients, Venofer is administered per consecutive hemodialysis session.
• For NDD-CKD patients, Venofer is administered on 5 different occasions over a 14 day period. Given the provided dosing regimens, Venofer should not be given daily 2.

From the Research

Administration Frequency of Venofer

• Venofer (iron sucrose) is typically administered intravenously, and its frequency of administration can vary depending on the patient's condition and the clinical setting.
• In a study published in 2001, Venofer was administered once per week for 5 doses in combination with erythropoietin (EPO) to predialysis chronic renal failure patients 3.
• Another study from 2003 used Venofer to correct iron deficiency in patients undergoing programmed hemodialysis, with the treatment regimen not explicitly stating a daily administration schedule 4.
• A 2006 study administered Venofer in 3 courses, intravenously, 200 mg at a 4-5 week interval during chemotherapy to anemic cancer patients, which does not indicate a daily schedule 5.
• A randomized, controlled trial from 2001 compared the efficacy and safety of iron sucrose (Venofer) vs iron gluconate (Ferrlecit) in haemodialysis patients, with Venofer administered once per month 6.

Daily Administration of Venofer

• There is no direct evidence from the provided studies to support the daily administration of Venofer.
• The studies suggest that Venofer can be administered weekly, monthly, or in a specific number of courses, depending on the patient's condition and the clinical setting.
• However, it is essential to consult the prescribing information and follow the recommended dosage and administration schedule for Venofer, as well as consider the individual patient's needs and medical history 3, 4, 5, 6.