Iron Sucrose

Iron Sucrose is a prescription medication used to treat Iron Deficiency Anemia. 

• Iron Sucrose is available under the following different brand names: Venofer 

Adult and Pediatric dosage

Injectable solution

• 20mg (Fe)/mL

Iron Deficiency Anemia

Adult dosage

• Hemodialysis-dependent CKD: 100 mg elemental iron IV (injection or infusion over 2-5 minutes) per dialysis session not to exceed total cumulative dose of 1000 mg divided in 3 doses per week
• Non-dialysis-dependent CKD: 200 mg IV injection for 5 doses in over 14 days (cumulative 1000 mg in in 14-day period)
• Peritoneal dialysis-dependent CKD: 300 mg IV infusion (1.5 hours) for 2 doses 14 days apart, then 400 mg IV infusion (2.5 hours) 14 days later (cumulative 1000 mg divided in 3 doses per week)

Pediatric dosage

• Children younger than 2 years of age: safety and efficacy not established
• Children 2 years or older: 
  • Hemodialysis-dependent: 0.5 mg/kg IV every 2 weeks for 12 weeks: not to exceed 100 mg/dose
  • Non-dialysis dependent or peritoneal-dependent (on erythropoietin): 0.5 mg/kg IV every 4 weeks for 12 weeks; nor to exceed 100 mg/dose

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Iron Sucrose include:

• fever, 
• cold or flu symptoms (sore throat, cough, stuffy nose, sneezing), 
• high or low blood pressure, 
• headache, 
• dizziness, 
• nausea, 
• vomiting, 
• diarrhea, 
• muscle or joint pain, 
• back pain, 
• pain or swelling in an arm or leg, 
• itching, and
• bruising or irritation at the injection site

Serious side effects of Iron Sucrose include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• itching, 
• rash, 
• lightheadedness, 
• problems with dialysis vein access point, 
• chest pain, 
• severe headache, 
• blurred vision, 
• pounding in the neck or ears, 
• pain or swelling, 
• bloating, 
• nausea, 
• vomiting, 
• loss of appetite, 
• diarrhea, and
• fever

Rare side effects of Iron Sucrose include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

Iron Sucrose has severe interactions with no other drugs.

Iron Sucrose has serious interactions with at least 14 other drugs. 

Iron Sucrose has moderate interactions with at least 30 other drugs.

Iron Sucrose has minor interactions with the following drugs:

• benazepril
• calcium acetate
• calcium carbonate
• calcium chloride
• calcium citrate
• calcium gluconate
• captopril 
• gymnema
• manganese 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity
• Anemia not caused by iron deficiency
• Iron overload

Effects of drug abuse

• None

Short-Term Effects

• See “What are Side Effects Associated with Using Iron Sucrose?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Iron Sucrose?”

Cautions

• Risk of hypotension
• Withhold therapy in tissue iron overload
• Hypersensitivity
• Serious hypersensitivity reactions reported, including anaphylactic-type reactions, some of which have been life-threatening and fatal
• Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse
• If hypersensitivity reactions or signs of intolerance occur during administration, stop infusion immediately
• Monitor patients for signs and symptoms of hypersensitivity during and after administration for at least 30 minutes and until clinically stable following completion of the infusion

Pregnancy and Lactation

• Published studies on intravenous iron sucrose treatment after first trimester of pregnancy not shown adverse maternal or fetal outcomes; available reports of intravenous iron sucrose use in pregnant women during first trimester are insufficient to assess risk of major birth defects and miscarriage; iron deficiency anemia during pregnancy should be treated because there are risks to mother and fetus associated with untreated iron deficiency anemia (IDA) in pregnancy; risks to fetus associated with maternal severe hypersensitivity reactions
• Severe adverse reactions including circulatory failure (severe hypotension, shock including in the context of anaphylactic reaction) may occur in pregnant women with parenteral iron products which may cause fetal bradycardia, especially during the second and third trimester. 
• Iron sucrose is present in human milk, and available published reports following exposure to 100-300 mg intravenous iron sucrose have not reported adverse reactions in breastfed infants; there are no data on effects on milk production
• Developmental and health benefits of breastfeeding should be considered, along with mother’s clinical need for treatment and any potential adverse effects on breastfed child from therapy or from underlying maternal condition