What is the recommended drip rate for iron sucrose in a 60 kg woman?

Iron Sucrose Drip Rate for a 60 kg Woman

For a 60 kg woman, iron sucrose should be administered at a dose of 200 mg IV over 60 minutes (3.33 mg/min). 1

Dosing Considerations

Iron sucrose is commonly used to treat iron deficiency anemia when oral iron is not tolerated or effective. The recommended administration parameters for iron sucrose are:

• Standard dose: 200 mg per infusion 1
• Maximum single dose: 200-300 mg 1, 2
• Infusion time: 60 minutes for 200 mg dose 1
• Maximum weekly dose: 500 mg 1

The dosing is not weight-based for adults in most situations, unlike in pediatric patients where weight-based dosing is used. For a 60 kg adult woman, the standard 200 mg dose is appropriate.

Administration Protocol

1. Preparation: Dilute 200 mg iron sucrose in 100-250 mL of 0.9% sodium chloride
2. Infusion rate: Administer over 60 minutes (3.33 mg/min)
3. Monitoring: Observe patient during infusion and for at least 30 minutes afterward
4. No test dose required: Unlike iron dextran, iron sucrose does not require a test dose 2

Safety Considerations

Iron sucrose has several advantages over other parenteral iron preparations:

• Lower risk of hypersensitivity reactions compared to iron dextran 1, 2
• No black box warning 2
• Well-tolerated with minimal side effects 3, 4

Potential Side Effects

• Hypotension (uncommon)
• Nausea
• Skin rash
• Injection site reactions

Clinical Efficacy

Iron sucrose has demonstrated excellent efficacy in treating iron deficiency anemia:

• Mean hemoglobin increase of 3.29 g/dL for women after treatment course 3
• Significant increase in serum ferritin levels from baseline 4
• Response rate (hemoglobin increase ≥2 g/dL) of 84% in female patients 3

Important Precautions

1. Avoid in active infection: Patients with active infection should not receive IV iron therapy 1
2. Monitor iron status: Regular monitoring of hemoglobin and ferritin is recommended 1
3. Avoid in first trimester of pregnancy: If needed during pregnancy, iron sucrose is considered safe after the first trimester 1, 5
4. Discontinue if hypersensitivity occurs: Although rare with iron sucrose, monitor for signs of hypersensitivity

Alternative Administration Options

For patients who cannot tolerate the standard infusion rate:

• Slow IV push: 200 mg over 2-5 minutes (for experienced providers) 1
• Extended infusion: Up to 90 minutes if needed for patient comfort

By following these guidelines, iron sucrose can be safely and effectively administered to a 60 kg woman to correct iron deficiency anemia with minimal risk of adverse effects.