Can Venofer (iron sucrose) be administered via intravenous (IV) push?

From the Guidelines

Venofer (iron sucrose) should not be administered as an IV push, but rather as a slow intravenous infusion or injection, with a minimum infusion time of 15 minutes for the maximum dose, as recommended by the European Medicines Agency (EMA) 1. The recommended administration method is either diluted in normal saline (typically 100 mL) and infused, or for smaller doses, administered as a slow IV injection at a rate not exceeding 1 mL (20 mg iron) per minute. Rapid administration of Venofer can cause hypotension, flushing, and other adverse reactions including potentially serious hypersensitivity reactions. The slow infusion rate allows for better monitoring of potential reactions and reduces the risk of side effects. Additionally, proper administration technique includes observing the patient during and after the infusion for signs of adverse reactions. Healthcare providers should follow their institution's specific protocols for iron infusion, which typically include vital sign monitoring before, during, and after administration, as supported by recent expert consensus guidelines 1. Some key points to consider when administering Venofer include:

• Minimum infusion time for the maximum dose: 15 minutes (EMA) or 30 minutes (FDA) 1
• Maximum single dose: 200 mg 1
• Maximum weekly dose: 500 mg 1
• Administration rate for slow IV injection: not exceeding 1 mL (20 mg iron) per minute 1 It is essential to prioritize the safety and well-being of patients when administering intravenous iron formulations, and to follow established guidelines and protocols to minimize the risk of adverse reactions.

From the FDA Drug Label

Venofer must only be administered intravenously either by slow injection or by infusion. Administer Venofer only intravenously by slow injection or by infusion. Administer Venofer 100 mg undiluted as a slow intravenous injection over 2 to 5 minutes, or as an infusion of 100 mg diluted in a maximum of 100 mL of 0.9% NaCl over a period of at least 15 minutes, per consecutive hemodialysis session Administer Venofer 200 mg undiluted as a slow intravenous injection over 2 to 5 minutes or as an infusion of 200 mg in a maximum of 100 mL of 0. 9% NaCl over a period of 15 minutes.

• Administration method: The FDA-approved label for Venofer recommends administration by slow intravenous injection or infusion.
• IV push: Although the term "IV push" is not explicitly mentioned, slow intravenous injection is recommended, which can be considered similar to an IV push, but it should be done over 2 to 5 minutes.
• Recommended dosage and administration: The label provides specific guidance on dosage and administration, including the use of slow intravenous injection or infusion, but it does not explicitly state "IV push" as an administration method. The answer is: No, Venofer should not be given as a rapid IV push, it should be administered as a slow intravenous injection over 2 to 5 minutes or as an infusion 2

From the Research

Administration of Venofer IV Push

• Venofer, also known as iron sucrose, is typically administered intravenously, but the provided studies do not specifically mention the administration of Venofer via IV push 3, 4, 5, 6, 7.
• The studies focus on the efficacy and safety of intravenous iron sucrose in treating iron deficiency anemia in various patient populations, including adults and children 3, 4, 5, 6.
• While the studies demonstrate the effectiveness of intravenous iron sucrose, they do not provide information on the specific administration method of IV push 3, 4, 5, 6, 7.

Safety and Efficacy of Intravenous Iron Sucrose

• The studies consistently show that intravenous iron sucrose is safe and effective in treating iron deficiency anemia, with significant increases in hemoglobin and ferritin levels 3, 4, 5, 6, 7.
• Adverse reactions to intravenous iron sucrose are rare, with some studies reporting mild side effects such as injection site disorders and transient taste perversion 5, 6.
• The use of intravenous iron sucrose has been shown to be effective in various patient populations, including adults, children, and pregnant women 3, 4, 5, 6, 7.

Dosage and Administration

• The dosage and administration of intravenous iron sucrose vary depending on the patient population and the specific treatment protocol 4, 5, 6, 7.
• The studies do not provide specific guidance on the administration of Venofer via IV push, and it is unclear whether this method is recommended or safe 3, 4, 5, 6, 7.