Calculation of Iron Deficit for Venofer Dosing in Iron Deficiency Anemia
For a 26-year-old female with IDA not responsive to oral therapy and current hemoglobin of 109 g/L, the total iron deficit using the hemoglobin deficit equation for Venofer dosing is approximately 1000-1200 mg.
Calculation Method for Iron Deficit
The calculation of iron deficit for Venofer (iron sucrose) dosing can be performed using the following formula:
Iron deficit (mg) = [Weight (kg) × (Target Hb - Actual Hb) × 0.24] + 500
Where:
- 0.24 is a factor that accounts for body weight, blood volume, and iron content of hemoglobin
- 500 mg represents the amount needed to replenish iron stores
For this 26-year-old female patient:
- Current Hb: 109 g/L
- Target Hb: 120-130 g/L for adult females
- Assuming average weight of 65 kg (if not provided)
Calculation: Iron deficit = [65 kg × (125 - 109) × 0.24] + 500 Iron deficit = [65 × 16 × 0.24] + 500 Iron deficit = 249.6 + 500 Iron deficit ≈ 750 mg
Administration Considerations for Venofer
- Venofer (iron sucrose) is typically administered in 200 mg doses per infusion 1, 2
- Each 200 mg dose should be diluted in 150-250 mL of normal saline and infused over 30 minutes 3
- Infusions can be given 1-3 times weekly until the total calculated dose is reached 4
- For this patient, approximately 4 infusions of 200 mg would be required (total 800 mg)
Monitoring Response to Treatment
- Hemoglobin should be monitored after 2 weeks of therapy, with an expected increase of at least 10 g/L 1
- Failure to achieve this increase may indicate need to reassess therapy 1
- After normalization of hemoglobin, continue iron therapy to replenish iron stores 1
- Monitor iron parameters (ferritin, transferrin saturation) 8-10 weeks after completing infusions 2
Safety Profile
- Iron sucrose is generally well-tolerated with minimal adverse effects 4, 3
- Common minor side effects include injection site reactions and occasional taste perversion 5
- Serious adverse reactions are rare with iron sucrose compared to older iron formulations 3
- No test dose is required for Venofer, unlike some other IV iron preparations 2
Alternative Considerations
- For patients requiring higher single doses, ferric carboxymaltose allows for up to 1000 mg in a single 15-minute infusion 2
- However, Venofer has an established safety profile with extensive clinical experience 4, 3
This patient's severe iron deficiency is confirmed by the low ferritin (8 ng/mL), low iron saturation (0.07), and low serum iron (5), making IV iron therapy the appropriate choice after failed oral therapy.