From the Guidelines
The recommended dosing regimen for Venofer (iron sucrose) in patients with iron deficiency anemia is 200 mg administered on 5 different occasions over a 14-day period for a total dose of 1000 mg, with a maximum single dose of 200 mg and a minimum infusion time of 10 minutes. This dosing regimen is based on the most recent and highest quality study available, which provides guidelines for the management of iron deficiency anemia 1. The study suggests that iron sucrose can be administered as a slow intravenous infusion or injection, with infusion typically over 15-60 minutes depending on the dose.
Key Considerations
- The maximum single dose of Venofer is 200 mg, and the minimum infusion time for this dose is 10 minutes, as recommended by the European Medicines Agency (EMA) 1.
- The dosing regimen may vary depending on the clinical scenario, such as hemodialysis-dependent chronic kidney disease patients, non-dialysis dependent CKD patients, and peritoneal dialysis patients.
- Patients should be monitored for hypersensitivity reactions during and after administration, particularly with the first dose.
- Treatment should be guided by laboratory parameters including hemoglobin, ferritin, and transferrin saturation levels.
Administration and Monitoring
- Venofer should be administered as a slow intravenous infusion or injection, with infusion typically over 15-60 minutes depending on the dose.
- Patients should be monitored for signs of hypersensitivity reactions, such as anaphylaxis, during and after administration.
- The medication works by replenishing iron stores needed for red blood cell production and hemoglobin synthesis.
Comparison with Other Iron Preparations
- The study also provides a comparison of different intravenous iron preparations, including iron dextran, ferric carboxymaltose, and ferric derisomaltose 1.
- The choice of iron preparation should be based on the individual patient's needs and medical history, as well as the potential risks and benefits of each preparation.
From the FDA Drug Label
2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion. The dosage of Venofer is expressed in mg of elemental iron. Each mL contains 20 mg of elemental iron.
1 Mode of Administration Administer Venofer only intravenously by slow injection or by infusion. The dosage of Venofer is expressed in mg of elemental iron. Each mL contains 20 mg of elemental iron.
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 [see How Supplied/Storage and Handling ( 16.2).]
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 dosing regimen for Venofer (iron sucrose) in patients with iron deficiency anemia is as follows:
- Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD): 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.
- Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD): 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, administered on 5 different occasions over a 14 day period. 2
From the Research
Venofer Dosing Regimen
The recommended dosing regimen for Venofer (iron sucrose) in patients with iron deficiency anemia varies depending on the patient population and the specific clinical context.
- For adult patients with iron deficiency anemia who have intolerance or show no effect with oral iron therapy, a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level is corrected or until receiving the total dose of intravenous iron calculated for each patient may be effective 3.
- In patients undergoing programmed hemodialysis, Venofer has been used to correct iron deficiency, with a significant increase in the number of patients with normal iron metabolism and achievement of target hemoglobin and hematocrit levels 4.
- In cancer patients with anemia, Venofer has been administered in 3 courses, intravenously, 200 mg at a 4-5 week interval during chemotherapy, resulting in improved hemoglobin levels and quality of life 5.
- In haemodialysis patients, iron sucrose (Venofer) has been compared with iron isomaltoside 1000 (Monofer) as maintenance therapy, showing similar efficacy and safety profiles 6.
Key Considerations
- The dosing regimen for Venofer should be individualized based on the patient's iron deficiency and clinical response.
- Monitoring of hemoglobin, hematocrit, and iron parameters is essential to adjust the dosing regimen as needed.
- Venofer has been shown to be well tolerated and effective in various patient populations, including those with chronic kidney disease and cancer.
Patient Populations
- Adult patients with iron deficiency anemia: 200 mg of intravenous iron sucrose weekly until hemoglobin level is corrected or total dose is reached 3.
- Patients undergoing programmed hemodialysis: Venofer to correct iron deficiency, with significant increase in patients with normal iron metabolism and achievement of target hemoglobin and hematocrit levels 4.
- Cancer patients with anemia: 200 mg of Venofer intravenously at 4-5 week interval during chemotherapy, resulting in improved hemoglobin levels and quality of life 5.
- Haemodialysis patients: iron sucrose (Venofer) as maintenance therapy, showing similar efficacy and safety profiles to iron isomaltoside 1000 (Monofer) 6.