From the Guidelines
For a patient with a ferritin level of 28 ng/mL, the typical dose of iron sucrose is 200-300 mg administered intravenously once or twice weekly for a total of 1000 mg, as recommended by the most recent guidelines 1. The frequency of administration and duration of benefit is dependent on the underlying etiology of the iron deficiency, with ongoing losses or conditions inhibiting iron absorption requiring multiple administrations 1. Key considerations for treatment include:
- Monitoring of hemoglobin, ferritin, and transferrin saturation levels after completion to assess response
- Observation for at least 30 minutes after administration due to the risk of hypersensitivity reactions
- Preference for iron sucrose over oral iron when rapid repletion is needed, in cases of oral iron intolerance, or with conditions affecting intestinal absorption
- Goal ferritin level of 50 ng/mL, regardless of sex at birth, in the absence of inflammation 1 The choice of intravenous iron formulation should be based on its registration for the specific age group or a proven good safety profile in adults during several years of postmarketing surveillance 1. Laboratory evaluation following IV iron should include a CBC and iron parameters (ferritin, percent transferrin saturation) 4 to 8 weeks after the last infusion, with hemoglobin concentrations expected to increase within 1–2 weeks of treatment and by 1 to 2 g/dL within 4–8 weeks of therapy 1.
From the Research
Iron Sucrose Dosage and Frequency
- The typical dose and frequency of iron sucrose in patients with ferritin levels of 28 ng/mL are not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest the following dosages and frequencies:
- 200 mg of intravenous iron sucrose per week until the hemoglobin level is corrected or until the total dose of intravenous iron calculated for each patient is received 2.
- 100 mg of iron sucrose can be administered over several minutes, and larger doses up to 300 mg can be administered within 60 minutes 3.
- 500 mg of intravenous iron sucrose infused over three hours on two consecutive days 4.
- It is essential to note that the dosage and frequency of iron sucrose may vary depending on the individual patient's needs and the underlying cause of iron deficiency anemia.
Factors Influencing Dosage and Frequency
- The patient's hemoglobin and serum ferritin levels, as well as their response to treatment, can influence the dosage and frequency of iron sucrose 2, 5.
- The presence of chronic kidney disease, heart failure, or other chronic inflammatory conditions may also impact the dosage and frequency of iron sucrose 3, 4, 6.
- The patient's ability to tolerate oral iron therapy and their adherence to treatment can also affect the dosage and frequency of iron sucrose 5, 6.