How is Venofer (iron sucrose) mixed?

How to Mix Venofer (Iron Sucrose)

Venofer (iron sucrose) can be administered either as a slow intravenous injection or as an infusion, with specific mixing instructions depending on the administration method and dose.

Preparation Options

• Venofer contains 20 mg of elemental iron per ml and is available in 100 mg (5 ml) vials 1

• For direct IV injection (slow IV push):

  • Can be administered undiluted at a rate of 100 mg over 2-5 minutes (FDA guidelines) 1
  • No dilution required for this method of administration 2

• For IV infusion:

  • Dilute in normal saline solution 1
  • Administer over 15 minutes (FDA guidelines) for doses up to 200 mg 1
  • Administer over 30 minutes (European Medicines Agency guidelines) for doses up to 200 mg 1

Dosing Considerations

• Maximum single dose: 200 mg 1
• Maximum weekly dose: 500 mg 1
• Typical administration is 100 mg per dose, which minimizes risk of arthralgia-myalgia reactions 1
• No test dose is required before administration (unlike iron dextran) 3, 2

Administration Precautions

• Monitor vital signs during and after infusion 4
• Resuscitation facilities should be available during administration due to potential for hypersensitivity reactions 4
• Bolus intravenous dosing of iron sucrose (200 mg iron) over 10 minutes is licensed and more convenient than a 2-hour infusion 4
• Free iron may occur if 100 mg is administered when transferrin levels are less than 180 mg/dL 1

Potential Adverse Effects to Monitor

• Hypotension and flushing (rare) 1, 5
• Abdominal cramps (rare, particularly when co-administered with ACE inhibitors) 1, 5
• Arthralgias and myalgias (acute rather than delayed) 1, 5
• These adverse effects are dose-related and rarely occur with doses of 100 mg or less 1

Clinical Efficacy Monitoring

• Transferrin and ferritin levels can be measured reliably 48 hours after IV administration 3
• Follow hemoglobin, ferritin, and transferrin saturation levels to assess response to therapy 5