From the Guidelines
Venofer (iron sucrose) should be ordered at a concentration of 20 mg/ml, with a maximum single dose of 200 mg and a maximum weekly dose of 500 mg, administered over a minimum infusion time of 15 min (FDA) or 30 min (EMA) for the max dose 1. When ordering Venofer, it is essential to consider the patient's iron deficiency severity and weight.
- For adults with iron deficiency anemia, a typical regimen is 200 mg IV administered over 2-5 minutes, given 1-3 times weekly until the desired total dose is reached.
- The total dose (in mg) can be calculated using the formula: [Weight in kg × (Target Hgb - Actual Hgb) × 0.24] + 500.
- For hemodialysis patients, 100 mg IV during each dialysis session is common. Key considerations for Venofer administration include:
- Administration in a monitored setting due to potential hypersensitivity reactions.
- Obtaining baseline labs including hemoglobin, ferritin, and transferrin saturation prior to administration.
- Monitoring vital signs and observing for adverse reactions like hypotension, nausea, or headache during treatment. Venofer works by replenishing iron stores needed for red blood cell production and hemoglobin synthesis, addressing the underlying cause of iron deficiency anemia rather than just treating symptoms, as supported by the most recent guidelines 1.
From the FDA Drug Label
2 DOSAGE & ADMINISTRATION Venofer must only be administered intravenously either by slow injection or by infusion. The dosage of Venofer is expressed in mg of elemental iron. Each mL contains 20 mg of elemental iron.
1 Mode of Administration Administer Venofer only intravenously by slow injection or by infusion. The dosage of Venofer is expressed in mg of elemental iron. Each mL contains 20 mg of elemental iron.
2 Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD) 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
3 Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD) 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.
The order for Venofer administration is as follows:
- Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD): 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.
- Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD): 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. 2
From the Research
Venofer Order Information
- Venofer, also known as iron sucrose, is a type of intravenous iron preparation used to treat iron deficiency anemia 3.
- It is particularly beneficial due to its ability to rapidly increase hemoglobin, ferritin, and transferrin saturation levels, with an acceptable safety profile 3.
- Iron sucrose has been used clinically since 1949 and has become a first-line treatment for certain conditions, such as end-stage kidney disease, chronic heart failure, and inflammatory bowel disease 3.
Administration and Dosage
- The dosage of Venofer is typically determined by the patient's iron deficiency and can be administered in a single dose or repeated doses over a period of 1-2 weeks 4.
- The treatment target for intravenous iron therapy, including Venofer, is an improvement in the quality of life, with hemoglobin being a surrogate marker 4.
Comparison with Other Iron Preparations
- Venofer has been compared to other intravenous iron preparations, such as ferumoxytol, in terms of efficacy and safety 5.
- Studies have shown that Venofer is at least comparable to ferumoxytol in patients with varying degrees of renal function 5.
- Venofer has also been compared to oral iron supplementation, with results suggesting that it may have a better gastrointestinal tolerability 6.
Safety Profile
- Venofer has a relatively safe profile, with a lower risk of severe infusion reactions compared to other intravenous iron preparations 4.
- However, all iron preparations are associated with a risk of severe infusion reactions, and individual selection of the appropriate iron therapy and evaluation of treatment response are mandatory to safely deliver improved outcomes 4.