What is the dose of Monofer (iron isomaltoside)

From the Guidelines

Monofer (iron isomaltoside) should be dosed at a maximum of 20 mg/kg body weight, up to 1000 mg iron, with a minimum infusion time of 15 min. This dosing recommendation is based on the most recent and highest quality study available, which is the 2018 ESMO clinical practice guidelines for the management of anaemia and iron deficiency in patients with cancer, published in the Annals of Oncology 1.

When considering the dosing of Monofer, several factors should be taken into account, including the patient's body weight and the severity of their iron deficiency. The guidelines provide a clear recommendation for the maximum infusion dose and minimum infusion time, which should be followed to minimize the risk of adverse reactions.

Some key points to consider when dosing Monofer include:

• The maximum infusion dose is 20 mg/kg body weight, up to 1000 mg iron
• The minimum infusion time is 15 min, although this may be longer if the dose exceeds 1000 mg iron
• The dose should be calculated based on the patient's individual needs, taking into account their body weight and the severity of their iron deficiency
• Patients should be monitored for hypersensitivity reactions during and after administration, particularly in the first 30 minutes.

Overall, the dosing of Monofer should be tailored to the individual patient's needs, and should be based on the most recent and highest quality evidence available, such as the 2018 ESMO clinical practice guidelines 1.

From the Research

Dosing of Monofer (Iron Isomaltoside)

The dose of Monofer (iron isomaltoside) varies depending on the patient's condition and the study. Here are some key points:

• In a study of patients with inflammatory bowel disease, iron isomaltoside 1000 was administered in single doses of 500-2000 mg infused over 15 minutes at 3-month intervals 2.
• In a study of patients with non-dialysis-dependent chronic kidney disease, iron isomaltoside 1000 was administered in maximum single doses of 1000 mg over 15 minutes 3.
• The development of Monofer has allowed for flexible dosing, including high and rapid dosing, with a maximum single dosage of 20 mg/kg body weight 4, 5.
• In a study of patients with chronic kidney disease, iron isomaltoside 1000 was administered as 4 intravenous bolus injections of 100-200 mg iron per dose or as a fast high-dose infusion 6.

Key Findings

Some key findings related to the dosing of Monofer include:

• The median cumulative 1-year dose of iron isomaltoside 1000 was 1.8 g in patients with inflammatory bowel disease 2.
• Iron isomaltoside 1000 was well tolerated and effective in treating iron deficiency anemia in patients with chronic kidney disease, with a low risk of adverse events 3, 6.
• The use of Monofer allows for convenient iron therapy for a wide range of patients, with a reduced risk of free iron toxicity 4, 5.

Administration

Monofer can be administered in different ways, including:

• Infusion over 15 minutes for doses up to 1000 mg 2, 3.
• Bolus injections of 500 mg over 2 minutes 3.
• Fast high-dose infusion for doses exceeding 1000 mg 4, 6.