What is the dose of iron sucrose (iron sucrose) for a 171-pound child with iron deficiency anemia?

Iron Sucrose Dosing for a 171-Pound Child with Iron Deficiency Anemia

For a 171-pound (approximately 77.6 kg) child with iron deficiency anemia, the recommended intravenous iron sucrose dose is 0.5 mg/kg, not to exceed 100 mg per dose. 1

Dosing Considerations

The FDA-approved dosing for iron sucrose (Venofer) in pediatric patients (2 years of age and older) is clearly defined based on the child's clinical situation:

• For children with hemodialysis-dependent chronic kidney disease (HDD-CKD):

  • 0.5 mg/kg (not exceeding 100 mg per dose) every two weeks for 12 weeks 1

• For children with non-dialysis dependent CKD or peritoneal dialysis-dependent CKD who are on erythropoietin therapy:

  • 0.5 mg/kg (not exceeding 100 mg per dose) every four weeks for 12 weeks 1

Administration Method

Iron sucrose should be administered:

• Undiluted by slow intravenous injection over 5 minutes, OR
• Diluted in 0.9% NaCl at a concentration of 1-2 mg/mL and administered over 5-60 minutes
• Do not dilute to concentrations below 1 mg/mL 1

Evaluation Before Treatment

Before initiating iron sucrose therapy, confirm iron deficiency anemia through:

• Hemoglobin level < 11.0 g/dL (CDC definition for children under 15 years) 2
• Complete blood count with red cell indices
• Serum ferritin ≤ 15 μg/L (confirms iron deficiency) 2

Alternative Oral Iron Therapy

If intravenous therapy is not necessary, oral iron remains the first-line treatment for iron deficiency anemia:

• Recommended oral elemental iron dosage: 3-6 mg/kg/day 2, 3
• For this 77.6 kg child, this would be approximately 233-466 mg of elemental iron daily
• Treatment should continue for 2-3 months total, even after hemoglobin normalizes 2

Monitoring Response

• Recheck hemoglobin after 4 weeks of therapy
• An increase in hemoglobin ≥1 g/dL confirms iron deficiency anemia
• If no response despite compliance, evaluate for other causes 2
• Continue treatment for 2-3 months total to replenish iron stores 2

Important Considerations

• Parenteral iron therapy is indicated when:

  • Oral therapy is ineffective
  • Anemia is severe
  • Rapid increase in hemoglobin is needed
  • Specific conditions exist (dialysis-dependent renal insufficiency, heart failure, active IBD) 4

• Untreated iron deficiency anemia in childhood can lead to:

  • Developmental delays
  • Behavioral alterations that may persist
  • Neurocognitive deficits 2, 3

Remember that iron therapy should be continued even after hemoglobin normalizes to fully replenish iron stores and prevent recurrence of iron deficiency anemia.