Iron Sucrose Dosing for Severe Anemia in a Young Female
For a 22-year-old female weighing 38.4 kg with severe anemia (Hb 4.5 g/dL), the appropriate iron sucrose dosage is 200 mg per session, administered intravenously over 10 minutes, with multiple sessions required to achieve the total iron deficit. 1
Calculation of Total Iron Deficit
To determine the total iron requirement, we need to calculate the patient's iron deficit:
- Iron deficit (mg) = Weight (kg) × (Target Hb - Actual Hb) × 2.4 + 500 mg for iron stores 1
- For this patient: 38.4 kg × (12 - 4.5) × 2.4 + 500 = 38.4 × 7.5 × 2.4 + 500 = 691.2 + 500 = 1191.2 mg
Administration Protocol
- Maximum single dose of iron sucrose (Venofer) is 200 mg per session 1
- Administration time: 10 minutes per 200 mg dose 1
- For this patient with severe anemia (Hb 4.5 g/dL), multiple sessions will be required to deliver the total calculated iron deficit 1
- Recommended schedule: 200 mg twice weekly until the total dose is administered (approximately 6 sessions) 1
Clinical Considerations
- The patient's severe anemia (Hb 4.5 g/dL) with symptoms of giddiness indicates urgent intervention 2
- Intravenous iron is preferred over oral iron in this case due to:
Monitoring and Follow-up
- Monitor vital signs during and after infusion due to risk of hypersensitivity reactions 1
- Resuscitation facilities should be available during administration 1
- Check hemoglobin levels after 1-2 weeks to assess response 1
- Continue monitoring hemoglobin and red cell indices at 3-month intervals for the first year after correction 1
Safety Considerations
- The incidence of side effects with iron sucrose is 22-29% 1
- Anaphylaxis is possible but less common with iron sucrose compared to iron dextran 1
- Ensure patient is monitored for at least 30 minutes after administration 1
- Consider dividing the total dose into multiple smaller doses to minimize adverse reactions 1