Calculation of Dosage: The dosage has to be individually adapted according to the total iron deficit calculated with the following formula:
Total iron deficit (mg) = body weight (kg) x target Hb - actual Hb (g/L) x 0.24* + depot iron (mg).
≤35 kg body weight target Hb = 130 g/L resp depot iron = 15 mg/kg body weight.
>35 kg body weight target Hb = 150 g/L resp depot iron = 500 mg.
* Factor 0.24 = 0.0034 x 0.07 x 1000.
Iron content of hemoglobin 0.34% blood volume = 7% of body weight/Factor 1000 = conversion from g to mg.
Total amount of iron sucrose injection to be administered (in mL) = Total iron deficit (mg) / 200 mg/mL. (See table.)
Click on icon to see table/diagram/image
If the total necessary dose exceeds the maximum allowed single dose, then the administration has to be split. If no response of the hematological parameters is observed after 1-2 weeks, the original diagnosis should be reconsidered.
Calculation of dosage for iron replacement secondary to blood loss and to support autologous blood donation: The required iron sucrose injection dose to compensate the iron deficit is calculated according to the following formulas:
If the quantity of blood lost is known: The administration of 200 mg IV iron (=10 mL iron sucrose injection) results in an increase in hemoglobin which is equivalent to 1 unit blood (=400 mL with 150 g/L Hb content). Iron to be replaced (mg) = number of blood units lost x 200 or amount of iron sucrose injection needed (mL) = number of blood units lost x 10.
If the Hb level is reduced: Use the previous formula considering that the depot iron does not need to be restored. Iron to be replaced (mg) = body weight x 0.24 x (target Hb - actual Hb) (g/L). Eg, body weight 60 kg, Hb deficit = 10 g/L = >Iron to be replaced 150 mg = >7.5 mL iron sucrose injection needed.
Adults and Elderly:
5-10 mL iron sucrose injection (100-200 mg iron) or 2-3 times a week depending on the hemoglobin level. Frequency of dosing should be no more than 3 times weekly.
0.15 mL iron sucrose injection/kg body weight (=3 mg iron/kg body weight) 2 or 3 times a week depending on the hemoglobin level.
Maximum Tolerated Single Dose: Adults and Elderly:
As Injection: 10 mL iron sucrose injection (200 mg iron) injected in at least 10 min. As Infusion: If the clinical situation demands, the single dose may be increased to 0.35 mL iron sucrose injection/kg body weight (=7 mg iron/kg body weight) not exceeding 25 mL iron sucrose injection (500 mg iron), diluted in 500 mL 0.9% NaCl infused over at least 3.5 hrs once a week.
Iron sucrose is used as a source of iron for iron deficiency anemia. Iron sucrose is to be administered IV by slow injection or by infusion or when used in hemodialysis patients, into the venous limb of the dialyser.
Infusion: Iron sucrose injection may preferably be administered by infusion. Iron sucrose may be given undiluted at the rate of 20 mg/min, after a test dose of 20 mg of iron has been given over 1-2 min. Alternatively, 100 mg is diluted in a maximum of 100 mL of 0.9% NaCl and the first 25 mg given as a test dose over 15 min; the remaining portion is given at a rate not exceeding 50 mL/15 min.
Slow IV Injection: Iron sucrose injection may be administered by slow IV injection at a rate of 1 mL undiluted per min (ie, 5 min/5 mL amp) not exceeding 5 mL iron sucrose injection (100 mg iron) per injection. After an injection, extend the arm of the patient.
Injection into Dialyser: Iron sucrose injection may be administered directly into the venous limb of the dialyser under the same conditions as for IV injection.