Intravenous (IV) iron sucrose has been established as a high potential medicinal product for reducing the burden of iron deficiency anemia (IDA). This agent overcomes the complications of compliance and absorption, in comparison to oral iron supplementation. It has an excellent safety record. Through a single total dose of iron sucrose infusion, it is possible to handle the commonest medical disorder of pregnancy, thereby dramatically diminishing maternal morbidity and mortality, while ameliorating the QoL of females in the developing world.
Indication: Intravenous (IV) iron sucrose is a safe and effective treatment option for adult patients with iron deficiency anemia who do not tolerate or lack satisfactory response to oral iron therapy. The iron sucrose iv is well tolerated and has a clinically manageable safety profile when using apt dosing and monitoring. It's indication include:
Intolerance to oral iron
Poor compliance to oral iron
Inadequate absorption due to gastrointestinal disorders; malabsorption, achlorhydria.
Lack of response to oral iron.
Pregnant women with severe iron deficiency anemia, presenting late in pregnancy.
As the first-line therapy in cases of moderate and severe iron deficiency anemia in 2'nd and 3'rd trimester of pregnancy.
Postpartum anemia.
Method of Administration
Monitor precisely patients for signs/symptoms of hypersensitivity reactions during and after each administration of Iron Sucrose. This medicine must only be given by the IV route. This may be either by a slow IV injection or by an IV drip infusion.
Intravenous Drip Infusion: The proposed dosage of iron sucrose is administered by IV Infusion:
Administer the infusion as every 2.5mL iron sucrose in 100mL of 0.9 percent NaCl at the rate of 100 mL/30 minutes.
Unused diluted solution needs to be discarded.
Maximum dosage: A maximum of 200 mg of elemental iron in 100 mL NS over 30 minutes, on alternate days given.
A total dose of 1.0 gm of iron sucrose can be administered in 4-10 sittings.
Intravenous Injection: The proposed dosage of Iron sucrose Injection may be given by slow IV injection at a rate of 1 mL undiluted solution per minute and not exceeding 10 mL iron sucrose (200 mg iron) per injection.
Prerequisites for Intravenous Iron Sucrose Therapy:
Recommended dosage of the inj iron sucrose should be given under precise supervision. At least a health specialist should be available while giving it. This is needed to handle anaphylactic shock.
Appropriate monitoring is needed in order to observe the infusion rate and patient vitals, mainly the pulse rate and blood pressure.
An emergency tray containing Adrenaline, injection, Hydrocortisone, and oxygen should exist for managing anaphylactic reactions.
The cardiopulmonary resuscitation facility should exist, if a patient collapses due to anaphylactic shock.
Contraindications to Iron Sucrose: Certain and a few general contraindications to iron sucrose injection are iron overload, non-iron deficiency anemia, and previous hypersensitivity to iron sucrose.
Adverse Reactions of Iron Sucrose
There can be nausea, joint ache, hypotension, headache, dizziness, paresthesia, vomiting, abdominal and muscle pain, edema, and cardiovascular collapse adverse reactions due to iron sucrose iv, which are rare in doses of 100 mg daily. They occur in case it is infused in a greater dose or the infusion rate is very slow and rapid (the norm of 100 mL/30 minutes needs to be followed).
Safety Profile: Safety profile of iron sucrose injection demonstrates:
rarely, and minimal side effects
reduced dose of Iron sucrose (100 mg Fe/kg) produces less or almost no side effects
allergic reactions: 3.3 cases/million/year
Availability and Price
Iron sucrose is supplied as 2.5 & 5 mL dosage strength, in single-dose ampoules. Single ampule of iron sucrose of 2.5 mL contains 50 mg and a single iron sucrose ampule of 5 mL contains 100 mg of elemental iron. The iron sucrose injection price is reasonable, economical and typically fluctuates from existing generic, biosimilar to innovator versions. This medicinal product is easily accessible from any WHO-GDP and ISO certified pharmaceutical wholesaler/supplier/distributor, in India.
Stability and Storage
This medicinal agent contains no preservatives. Store iron sucrose ampule in original carton at temperature 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). It is not advisable to freeze this medication.
NOTE: Deets mentioned in this article is for informational or educational purposes only, and does not substitute professional medical advice or consultations with health specialists.