From the Guidelines
The recommended dose interval for IV iron sucrose is 100 mg administered 1-3 times weekly, with a maximum single dose of 100 mg, as this dose can be given safely and effectively, according to the most recent guidelines 1.
Key Considerations
- The dose of IV iron sucrose should be individualized based on the patient's iron deficiency and clinical response, with a maximum weekly dose of 300-400 mg not typically exceeded in practice, although the exact upper limit may vary depending on the patient's condition and the clinician's judgment.
- Each dose should be infused slowly over at least 15-30 minutes to minimize the risk of adverse reactions, such as hypotension, flushing, and other infusion reactions.
- For patients with iron deficiency anemia, a common regimen is 100 mg given 1-2 times per week until the total calculated iron deficit is reached, with the goal of replenishing iron stores while minimizing adverse effects.
- For maintenance therapy in hemodialysis patients, 100 mg 1 time weekly is often used, as this dose can help maintain adequate iron stores and support erythropoiesis.
Administration and Monitoring
- Iron sucrose has a relatively good safety profile compared to other IV iron preparations, but patients should still be monitored for signs of hypersensitivity during and after administration, including monitoring of vital signs and observation for any adverse reactions.
- Adequate spacing between doses allows for better tolerance and assessment of response, while dividing the total iron requirement into multiple smaller doses helps minimize adverse effects while effectively replenishing iron stores, as supported by the guidelines 1.
Evidence-Based Recommendations
- The most recent guidelines recommend using IV iron formulations that can be administered in a replacement dose of 1000 mg (or more) in a single 15 to 60-min visit, but iron sucrose is typically given in smaller doses due to its pharmacokinetic properties and the risk of infusion reactions 1.
- The guidelines also emphasize the importance of individualizing the dose and administration schedule based on the patient's clinical response and iron deficiency, as well as monitoring for adverse reactions and adjusting the treatment plan as needed 1.
From the Research
Recommended Dose Interval for Intravenous Iron Sucrose
The recommended dose interval for intravenous (IV) iron sucrose varies depending on the patient population and the specific clinical trial.
- In a North American clinical trial 2, iron sucrose was administered in 10 doses, each administered undiluted as 100 mg IV push over 5 minutes, without a prior test dose.
- In a randomized controlled trial 3, patients treated with hemodialysis received study medication once every other week for 6 doses, while patients in the nonhemodialysis group received study medication once every 4 weeks for 3 doses.
- In a study evaluating the efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia 4, patients received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.
- In a study examining the safety of iron sucrose in hemodialysis patients intolerant to other parenteral iron products 5, therapy with iron sucrose consisted of 100- or 200-mg doses administered undiluted intravenously over 2-5 min, or diluted in normal saline and infused over 15-30 min, with a median cumulative dose of 1,000 mg.
- In a North American clinical trial 6, patients were administered 100 mg of IV iron sucrose in each of 10 consecutive dialysis treatment sessions.
Key Findings
- The studies demonstrate the safety and efficacy of iron sucrose in various patient populations, including those with dialysis-associated anemia and iron deficiency anemia 2, 3, 4, 5, 6.
- The dose interval and administration route may vary depending on the specific patient population and clinical trial 2, 3, 4, 5, 6.