Iron Sucrose Therapy for Iron Deficiency Anemia in a 24-Year-Old Female
For a 24-year-old female with iron deficiency anemia (hemoglobin 8 g/dL) and breathlessness on walking, the recommended dosage is 200 mg IV iron sucrose administered over 30-60 minutes, given once weekly until the calculated iron deficit is corrected, with a total dose not exceeding 1000 mg. 1
Dosing Regimen
- Initial dose: 200 mg IV iron sucrose infused over 30-60 minutes
- Frequency: Once weekly
- Duration: Until calculated iron deficit is corrected (typically 3-5 doses)
- Maximum total dose: 1000 mg
Calculation of Iron Deficit
The iron deficit can be calculated based on the patient's hemoglobin level and body weight. For a patient with hemoglobin of 8 g/dL, the formula is:
Iron deficit (mg) = [Target Hb - Actual Hb] × Weight (kg) × 2.4 + 500
Where:
- Target Hb is typically 12 g/dL for women
- 500 mg represents iron stores
Administration Guidelines
- No test dose is required for iron sucrose, unlike iron dextran 1
- The patient should be observed for at least 30 minutes following each IV injection to monitor for adverse reactions 1
- If paravenous leakage occurs during administration, the infusion must be stopped immediately to prevent skin staining/discoloration 1
Monitoring
- Hemoglobin levels should be monitored every 4 weeks until normalization 1
- Once hemoglobin normalizes, check complete blood count at 3-month intervals for 12 months, then 6-monthly for 2-3 years 1
- Iron status should be re-evaluated 3 months after administration, as serum ferritin levels increase markedly following IV iron administration and cannot be utilized as a reliable marker within 4 weeks 1
Expected Response
Iron sucrose therapy is effective in achieving target hemoglobin levels in approximately 80% of patients with iron deficiency anemia 2. Most patients show significant improvement in hemoglobin levels within 2 weeks of therapy 2.
Safety Profile
- Iron sucrose has a favorable safety profile compared to other IV iron preparations 1
- The most common adverse effects include dizziness, headache, hypertension, injection-site reactions, and nausea (occurring in 1-10% of patients) 1
- Severe reactions are rare and typically occur with infusion of larger iron doses 3
Contraindications
Iron sucrose is contraindicated in:
- Patients with hypersensitivity to iron sucrose or any components
- Anemia not attributed to iron deficiency
- Evidence of iron overload
- Active infection 1
Advantages Over Oral Iron
For this patient with symptomatic anemia (breathlessness on walking) and a hemoglobin of 8 g/dL, IV iron therapy offers several advantages:
- Avoids gastrointestinal side effects common with oral preparations (nausea, constipation, diarrhea)
- Provides more rapid correction of iron deficiency 1
- More effective in rapidly improving exercise tolerance and symptoms in patients with anemia 4
Iron sucrose therapy is particularly beneficial for this patient with symptomatic anemia, as it will help alleviate breathlessness more quickly than oral iron supplementation while avoiding gastrointestinal side effects.