How to calculate the dose of Venofor infusion IV?

How to Calculate Venofer (Iron Sucrose) IV Dose

Venofer must only be administered intravenously either by slow injection or by infusion, with dosage expressed in mg of elemental iron. Each mL of Venofer contains 20 mg of elemental iron. 1

Dosing Guidelines by Patient Population

Adult Patients with Hemodialysis-Dependent Chronic Kidney Disease (HDD-CKD):

• Administer 100 mg undiluted as a slow IV injection over 2-5 minutes, OR
• Administer 100 mg diluted in maximum 100 mL of 0.9% NaCl over at least 15 minutes
• Give during each consecutive hemodialysis session (generally within first hour)
• Usual total treatment course: 1000 mg
• May repeat if iron deficiency recurs 1

Adult Patients with Non-Dialysis Dependent CKD (NDD-CKD):

• Option 1: Administer 200 mg undiluted as slow IV injection over 2-5 minutes, OR
• Option 1 (alternate): Administer 200 mg in maximum 100 mL of 0.9% NaCl over 15 minutes
  • Give on 5 different occasions over a 14-day period
• Option 2: Administer 500 mg diluted in maximum 250 mL of 0.9% NaCl over 3.5-4 hours on Day 1 and Day 14 1

Adult Patients with Peritoneal Dialysis Dependent CKD (PDD-CKD):

• Administer in 3 divided doses within a 28-day period:
  1. 300 mg over 1.5 hours
  2. 300 mg over 1.5 hours (14 days after first dose)
  3. 400 mg over 2.5 hours (14 days after second dose)
• Dilute in maximum 250 mL of 0.9% NaCl 1

Pediatric Patients (2 Years and Older) with HDD-CKD for Iron Maintenance:

• Administer 0.5 mg/kg (not exceeding 100 mg per dose) every two weeks for 12 weeks
• Give undiluted by slow IV injection over 5 minutes, OR
• Dilute in 0.9% NaCl at concentration of 1-2 mg/mL and administer over 5-60 minutes
• Do not dilute to concentrations below 1 mg/mL 1

Pediatric Patients (2 Years and Older) with NDD-CKD or PDD-CKD on Erythropoietin:

• Administer 0.5 mg/kg (not exceeding 100 mg per dose) every four weeks for 12 weeks
• Give undiluted by slow IV injection over 5 minutes, OR
• Dilute in 0.9% NaCl at concentration of 1-2 mg/mL and administer over 5-60 minutes
• Do not dilute to concentrations below 1 mg/mL 1

Preparation and Administration Steps

1. Calculate the dose based on patient category and condition
2. Determine administration method (slow IV injection vs. infusion)
3. Prepare the solution:
   • For undiluted administration: Draw required volume (remember: 20 mg iron per mL)
   • For diluted administration: Dilute in appropriate volume of 0.9% NaCl
4. Administer at appropriate rate according to protocol

Important Considerations

• Venofer must ONLY be administered intravenously 1
• Each mL contains 20 mg of elemental iron (for calculating volume needed) 1
• Do not mix with other medications or add to parenteral nutrition solutions
• Monitor patients for signs of hypersensitivity during and after administration
• The pharmacokinetics show that injected iron(III)-hydroxide sucrose complex is cleared from serum with a terminal half-life of approximately 5-6 hours 2

Clinical Efficacy Note

Studies have shown that IV iron administration can effectively improve anemia in CKD patients, with a mean increase in hematocrit of 2.74% when used alone and 4.54% when combined with erythropoietin 3

By following these guidelines, you can accurately calculate and administer Venofer infusions to achieve optimal therapeutic outcomes while minimizing risks of adverse effects.