- For the treatment of iron deficiency anemia in adult patients who have intolerance or unresponsiveness to oral iron therapy
- Available as a 100mg/mL solution
- Store unused vials between 15-30C. Do not freeze
- Single-use vials. Discard remaining unused solution
- Diluted solutions should be not be stored. Use immediately
- Compatible: 0.9% sodium chloride
- Additives/Above Cassette Compatible: none
- Y-site Compatible: none
- Incompatible: do not mix with other drugs, parenteral nutrition solutions, or solutions other than 0.9% sodium chloride
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
YES - Not recommended Doses ≤ 500mg only Usual dilution:
Infusion rate: do not exceed 250 mg/minute |
| IV intermittent infusion |
YES – PREFERRED Infusion time: 120 minutes |
| IV Continuous Infusion | NO |
| Injection into dialyzer |
YES May be administered during a hemodialysis session directly into the venous limb of the dialyzer under the same procedures as outlined above for “IV Direct”. |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
**All doses (mg) are expressed in terms of elemental iron**
Pediatric (2 years and older) and Adults:
- 20 mg/kg (suggested maximum: 1,000 mg; absolute maximum: 1,500 mg), or;
- Simplified dosing table
| Hgb (g/L) | Weight: <50kg | Weight 50kg - <70kg | Weight ≥ 70kg |
| ≥100 | 20 mg/kg | 1000mg | 1000mg - 1500mg |
| <100 | 20 mg/kg | 1000mg - 1500mg | 1000mg - 1500mg |
Maximum dose:
-
20 mg/kg or 1,500 mg as a single IV infusion (whichever is less). Doses above 1,500 mg are not recommended.
-
If cumulative iron requirement exceeds 20 mg/kg, this must be split in two or more administrations at an interval of at least one week. It is suggested to use 20 mg/kg as the first administration.
Simplified table:
| Hgb (g/L) | Weight: <50 kg | Weight: 50kg to <70kg | Weight: ≥ 70 kg |
| ≥ 100 | 20 mg/kg | 1,000mg | 1,000 - 1,500mg |
| < 100 | 20 mg/kg | 1,000 - 1,500mg | 1,000 - 2,000mg |
- Monitor: BP q15min and continuous cardiorespiratory monitoring during infusion and for at least 30 minutes afterwards.
- Hypersensitivity: Anaphylaxis, urticaria, angioedema
- Administration-site reactions: Extravasation injury, phlebitis, venous spasm
- Hypotension (especially with rapid administration)
- Fever, chills
- Headache, dizziness
- Myalgia, arthralgia, paresthesia
- Reduced absorption of oral iron
- Hypophosphatemia
- Fishbane reaction: chest tightness, flank and back pain, face flushing (WITH stable vitals).
- Suggest: STOP infusion, may provide fluid bolus with 0.9% sodium chloride. Restart infusion once pain subsides; consider reduced infusion rate.