Use Caution/Monitor. Methods. It can be expressed in mg per ml. Recommended starting dose 1 Aranesp is dosed at 2.25 mcg/kg SC QW or 500 SC Q3W 1 (SC = subcutaneous) Before initiating 1: Evaluate iron status; administer supplemental iron therapy as needed Correct or eliminate other causes of anemia Initiate 1: Only when Hb < 10 g/dL Avoid or Use Alternate Drug. Option 2: 200 mg in NS 100 mL administered over 20-30 minutes; may repeat every other day to The factor 2.4 is derived from the following assumptions: a) Blood volume 70 ml/kg of body weight ~7% of body weight b) Iron content of hemoglobin 0.34% Factor 2.4 = 0.0034 x 0.07 x 10000 (conversion for g/dL) Ganzoni AM. Patients diagnosed with iron deficiency are prescribed iron supplementation, either to replete body stores or to correct anemia. Use Caution/Monitor. There is no resource limitation, as if the tool was hosted on your site, so all your users can make use of it 24/7; The necessary tool updates will take place in real time with no effort on your end; A single click install to embed it into your pages, whenever you need to use it. Adult Patients: The most common adverse reactions (2%) include diarrhea, nausea, vomiting, headache, dizziness, hypotension, pruritus, pain in extremity, arthralgia, back pain, muscle cramp, injection site reactions, chest pain and peripheral edema. Crown Rump Length and Nuchal Translucency. Serious - Use Alternative (1)iron sucrose decreases levels of ciprofloxacin by inhibition of GI absorption. 3) Auerbach M, Witt D, Toler W, Fierstein M, Lerner RG, Ballard H. (1988) Clinical use of the total dose intravenous infusion of iron dextran. All Rights Reserved. For adult CKD patients on ESA therapy who are not receiving iron supplementation, the guideline suggests a trial of IV iron (or in NDD-CKD patients, alternatively, a 1- to 3-month trial of oral iron therapy) if: CKD=chronic kidney disease ESA=erythropoietin-stimulating agent Hb=hemoglobin IV=intravenous RBC=red blood cell WBC=white blood cell. Test Dose: Not required. No additional iron to replenish stores. Venofer [package insert]. No data are available regarding overdosage of Venofer in humans. Administer a test INFeD dose prior to the first therapeutic dose. Iron Sucrose [ Venofer ] Elemental iron: 20 mg/mL (2.5 mL, 5 mL, 10 mL) Solution, Intravenous [preservative free]: [package insert] INDICATIONS: Venofer is an iron replacement product indicated for the treatment of iron deficiency anemia in patients with chronic kidney disease (CKD). These adverse reactions have occurred up to 30 minutes after the administration of Venofer injection. Applies only to oral form of both agents. I. Suggested regime: Prescribing instructions Prescribing a single/first dose: Separate by 2 hr. Sodium ferric gluconate complex injection [ Ferrlecit ] [package insert] - Elemental iron: 12.5 mg/mL (5 mL). . Where C is the concentration of the iron product: Please note that the calculations above are for information purposes only and the individual dose needs to be established by taking into account the current package insert for the elemental iron product used. Applies only to oral form of both agents. Calculation of total iron deficit for initial repletion: [29] Total cumulative dose (mg) = [Target Hb Actual Hb] weight (kg) 2.4 + [15 weight (kg)] *Hb in g/dl: 2. Chandler G, Harchowel J, Macdougall I. Dose. calcium acetate decreases levels of iron sucrose by inhibition of GI absorption. This drug is available at a middle level co-pay. IDA symptoms vary, may not be specific and include tiredness, weakness, shortness of breath. Interaction only with oral iron administration. Most Ferritin and transferrin are also recommended monitoring . Koch TA, Myers J, Goodnough LT. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. Serious - Use Alternative (1)iron sucrose decreases levels of doxycycline by inhibition of GI absorption. MISSED DOSE: It is important to get each dose of this medication as scheduled. Last updated 28/06/2018 Enter values here and press 'Calculate'. Applies only to oral form of both agents. Adverse pregnancy outcomes associated with IDA include increased risk for preterm delivery and low birth weight. Applies only to oral form of both agents. Kumpf VJ, Holland EG. Serum iron, total iron binding capacity (TIBC) and percent saturation of transferrin are other important tests for detecting and monitoring the iron deficient state. Modify Therapy/Monitor Closely. ADMINISTER THE TEST DOSE AT A GRADUAL RATE OVER AT LEAST 30 SECONDS. Below the form there are further instructions on how to use the calculator. Applies only to oral form of both agents. Applies only to oral form of both agents. Administer Venofer early during the dialysis session (generally within the first hour). A patients lean body weight (or actual body weight if less than lean body weight) should be utilized when determining dosage. 1. Iron deficiency anemia calculator (diagnosis), Iron deficiency anemia vs. commonly, these are "preferred" (on formulary) brand drugs. Use Caution/Monitor. Applies only to oral form of both agents. Burns DL, Mascioli EA, Bistrian BR. Canada residents can call a provincial poison control center. 2) Koch TA, Myers J, Goodnough LT. (2015) Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations. This health tool computes the required parenteral iron replacement dose for the iron deficit extracted from the patient weight and hemoglobin level from complete blood count test. . We comply with the HONcode standard for trustworthy health information. famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. Monitor Closely (1)iron sucrose decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Where: Medicine concentration Amount of active substance per a given volume of your drug. By entering this website, you acknowledge that you are a licensed healthcare professional practicing in the United States. Dosing Considerations (8-10) Maximum single dose of iron sucrose in all other patients is 300 mg every week. Applies only to oral form of both agents. There are physiological variation in iron reserves such as the decrease during menstruation period. Modify Therapy/Monitor Closely. This information does not assure that this product is safe, effective, or appropriate for you. Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Venofer. Iron deficiency can occur at any stage of life, due to physiological demands, for example, during pregnancy, childhood growth or prolonged periods of sickness. Applies only to oral form of both agents. iron sucrose decreases levels of ibandronate by inhibition of GI absorption. FERAHEME was non-inferior to Venofer (iron sucrose) in mean Hgb rise from baseline 2,5. There is limited experience with administration of an infusion of 500 mg of Venofer, diluted in a maximum of 250 mL of 0.9% NaCl, over a period of 3.5 to 4 hours on Day 1 and Day 14. Use Caution/Monitor. Monitor Closely (1)dexlansoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. The cost of Venofer is $145 for a dose of 300 mg and Monoferric is $274 for a dose of 500mg. USES: This medicine is used to treat "iron-poor" blood (anemia) in people with long-term kidney disease. Use Caution/Monitor. Minor/Significance Unknown. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Applies only to oral form of both agents. Slowing the infusion rate may alleviate symptoms. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Since this is less than the threshold of total dose of 20 mg/kg, the deficit can be eliminated with a single infusion. Applies only to oral form of both agents. This drug is available at a higher level co-pay. Use Caution/Monitor. Prescribing and dispensing information For iron sucrose A complex of ferric hydroxide with sucrose containing 2% (20 mg/mL) of iron. Iron metabolism needs to be balanced and bleeding, the major cause of iron deficiency (for instance in menstruation in females and chronic occult gastrointestinal bleeding) needs to be addressed. (2010) Diagnosis and management of iron deficiency anaemia: a clinical update. Due Date form Ultrasound Report. It is usually given slowly over 2 to 5 minutes or as directed by your doctor. Use Caution/Monitor. Either decreases levels of the other by inhibition of GI absorption. Monitor Closely (1)deferoxamine decreases levels of iron sucrose by inhibition of GI absorption. The incidence of adverse events with the 400- and 500-mg doses administered as a 2-hour . Where C= concentration of elemental iron (mg/ml) in the product being used: Data from Ferrlecit postmarketing spontaneous reports indicate that individual doses exceeding 125 mg may be associated with a higher incidence and/or severity of adverse events, Adult Patients with Hemodialysis Dependent-Chronic Kidney Disease (HDD-CKD), Adult Patients with Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD), WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS, Iron Deficiency and Anemia- signs and therapeutic options. Maximum recommended single dose: 300 mg (See Prescriber's Orders). Schrier SL, Mentzer WC, Landaw SA. Philadelphia, PA: Lippincott Williams & Wilkins;2013;303-307. Applies only to oral form of both agents. Applies only to oral form of both agents. This site complies with the HONcode standard for trust- worthy health information: verify here. Follow your doctor's directions carefully.Tell your doctor right away if you have any serious side effects, including: abdominal pain, chest pain, irregular heartbeat (arrhythmias), pressure in the chest, severe headache and blurred vision (hypertension), problems with your dialysis access site (graft).A very serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Do not dilute to concentrations below 1 mg/mL [see How Supplied/Storage and Handling (16.2).] Applies only to oral form of both agents. Use Caution/Monitor. Evaluate the hematologic response (hemoglobin, ferritin, iron and transferrin saturation) at least one month following the second Feraheme infusion. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: vitamin products, other iron-containing products. sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron sucrose by inhibition of GI absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Diagnosis and management of iron deficiency anaemia: a clinical update. The factor 2.4 comes about from the calculation that the total iron content of hemoglobin is 0.34%, the blood volume accounts for 7% . Use Caution/Monitor. Applies only to oral form of both agents. Applies only to oral form of both agents. Fulminant symptoms may include general paleness, confusion or episodes of passing out. Each mL contains 20 mg of elemental iron. Monitor Closely (1)lansoprazole will decrease the level or effect of iron sucrose by increasing gastric pH. Use Caution/Monitor. 2000 Jan;22(1):39-43. Use Caution/Monitor. The recommendation is that most adults need a cumulative dose of elemental iron of at least 1 g. Iron replenishment can be done intravenously, either as total dose (example: iron-dextran or iron carboxymaltose) or as split dose (example: iron sucrose). Monitor Closely (1)deferasirox decreases levels of iron sucrose by inhibition of GI absorption. calcium chloride decreases levels of iron sucrose by inhibition of GI absorption. Accessed: 4/12/2011. The dosage of Venofer is expressed in mg of elemental iron. 2010;18(3). J Med. 1. Auerbach M, Witt D, Toler W, Fierstein M, Lerner RG, Ballard H. Clinical use of the total dose intravenous infusion of iron dextran. Many patients with kidney disease cannot get enough iron from food and require injections. Am J Kid Dis 2001; 38 988991. World J Gastroenterol; 16(22): 27202725. Pediatric Patients (2 Years of Age and Older). Applies only to oral form of both agents. Venofer treatment may be repeated if iron deficiency reoccurs. Schweiz Med Wochenschr; 100(7):301-3. Although the original formula requires the weight in kilograms, values input in lbs are transformed. This health tool computes the iron deficit based on patient parameters and the Ganzoni formula. Monitor Closely (1)iron sucrose decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. In case a pediatric patient with a weight below 35 kg is assessed, iron stores are calculated as 15 mg iron for each kg. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Most Applies only to oral form of both agents. Serious - Use Alternative (1)iron sucrose decreases levels of fleroxacin by inhibition of GI absorption. This information is not individual medical advice and does not substitute for the advice of your health care professional. Privacy Policy, Use 500 mg for adults and children 35 kg; use 15 mg/kg if <35 kg. All you have to do is use the following formula: Liquid\ dose = Dose / Medicine\ concentration Liquid dose = Dose/M edicine concentration. Use Caution/Monitor. Dr. Ganzonis primary research is focused on iron deficiency and plasma iron transport. informational and educational purposes only. Anemias. 10th ed. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. HOW TO USE: This medication is given by injection into a vein as directed by your doctor. Your doctor will do laboratory tests to monitor your response. iron sucrose, benazepril. Allow at least 30 minutes between administration of Feraheme and administration of other medications that could potentially cause serious hypersensitivity reactions and/or hypotension, such as chemotherapeutic agents or monoclonal antibodies. Nutrition. Treatment of anemia due to iron deficiency. iron sucrose increases levels of calcium gluconate by enhancing GI absorption. . Venofer treatment may be repeated if necessary. -Hgb deficit (grams) = Hgb deficit (g/dL) x blood volume (dL) -Iron deficit (mg) = Hgb deficit (grams) x 3.3 (mg Fe/g Hgb) [Note: 3.3 x 0.65 = 2.145] Serious - Use Alternative (1)iron sucrose decreases levels of ofloxacin by inhibition of GI absorption.