Iron dextran vs iron sucrose

As part of the North American clinical trials for iron sucrose injection we examined the effect of intravenous IV iron sucrose in 23 hemodialysis patients with documented sensitivity to iron dextran ongoing epoetin alfa therapy and below-target-range hemoglobin Hgb levels. Iron dextran CosmoFer can be given as a total dose infusion iron sucrose Venofer is given as divided doses.

0 54 mg system A and 547 2359 mg for system B.

Iron dextran vs iron sucrose. Maximum tolerated dose MTD As injection. MTD per day max. 200mg iron given 3 times per week.

Maximum tolerated single dose per day max. 500 mg given once per week. Give each dose over at least 35 hours Patient 70 kg.

500 mg iron sucrose. Patient 70 kg. 7 mg ironkg body weight.

Immediate ADRs were similar between the two study arms. Iron dextran 873 11 and iron sucrose 570 7 p0568. The average additional nursing time required to manage immediate ADRs was approximately 30 minutes.

Delayed ADRs approached statistical significance with a higher rate of ADRs in the iron sucrose group iron dextran 973 12 and iron sucrose 1870 26 p00541. If total dose of iron needed is high then iron dextran is preferred since the adverse events are not any higher than iron sucrose. But initial test dose is necessary before giving full desired dose for iron dextran.

Repletion regimen of iron sucrose given as a 500 mg infusion over 3 hours. Their recommendations are based on two premises. first that iron dextran is less safe than iron sucrose Venofer.

Ameri-can Regent USA and Vifor Switzerland and second that the higher-than-rec-ommended dosing of iron sucrose5 is justified by a considerably increased. Confidence that iron sucrose or any other formulation of iron for intravenous administration is clearly safer than iron dextran. At least part of the negative safety record of iron dextran is linked with its extensive use over the past 30 to 40 years.

From this record it can be said that the incidence of severe adverse effects is roughly. Iron sucrose IS Venofer Vifor Pharma is administered as an intravenous infusion containing 200 mg of iron over two hours and subsequent doses may be given at 48-hour intervals until the desired dose of iron has been achieved. Iron dextran ID CosmoFer Vitaline Pharma is given as an intravenous infusion containing any dose up to 2000 mg of iron depending upon the patients calculated iron.

Iron sucrose and iron dextran dialysate concentration was below the lower limits of assay 2 ppm for system A. Dialysate recovery of iron was negligible. 0 54 mg system A and 547 2359 mg for system B.

Dialyzer type or UFR did not affect iron removal. At first exposure when compared with iron sucrose the adjusted OR of anaphylaxis for iron dextran was 36 95 CI 24-54. For iron gluconate 20 95 CI 12 35.

And for ferumoxytol 22 95 CI 11-43. The estimated cumulative anaphylaxis risk following total iron repletion of 1000 mg administered within a 12-week period was highest with iron dextran 82 per 100 000 persons 95 CI 705- 931 and lowest with iron sucrose. As part of the North American clinical trials for iron sucrose injection we examined the effect of intravenous IV iron sucrose in 23 hemodialysis patients with documented sensitivity to iron dextran ongoing epoetin alfa therapy and below-target-range hemoglobin Hgb levels.

We assigned patients to treatment groups according to whether reactions they had experienced to iron dextran. Lowmolecularweight iron dextran CosmoFer is the only form of parenteral iron that can be administered as a total dose infusion TDI in the United Kingdom UK. This study aimed to evaluate the safety and efficacy of TDI CosmoFer in comparison to intravenous iron sucrose infusion Venofer in patients with chronic kidney disease CKD.

Abundant evidence has established iron sucrose as a safe and effective alternative to iron dextran in patients with normal renal function19 20 21 22 23 24 25 26 and those with chronic renal failure6 7 8 27 28 29 30 In literature spanning nearly 50 years of experience with iron sucrose serious reactions have been reported rarely31 32 33 Although the recommended rate of. INVESTIGATION OF 1000 mg INTRAVENOUS IRON SUCROSE DOSES In an attempt to further simplify intravenous iron sucrose therapy in anemic iron-deficient CKD patients an approach analogous to iron dextran total dose infusions was explored. We prospectively studied the tolerability of 1g intravenous iron sucrose infusions.

The term iron saccharate has been used for decades in Europe and elsewhere to describe not only Venofer iron sucrose injection but also other intravenous IV iron products that are similar but different from Venofer in terms of dosing regimens adverse event profiles and rates of discontinuations due to adverse events. There is only one iron sucrose injection which is the official. The requirement to complete the dose ie.

Iron dextran CosmoFer can be given as a total dose infusion iron sucrose Venofer is given as divided doses. THIS PROTOCOL REFERS TO LOW MOLECULAR WEIGHT IRON DEXTRAN COSMOFER 16 Response Due to iron metabolic pathways a rise in reticulocyte count will occur during the second week and thereafter provided. The 2 popular forms of available parenteral iron in the United States are iron dextran and iron gluconate.

Despite their value intravenous iron therapy carries the potential for serious allergic reactions. In 1980 Hamstra et al examined over 2000 infusions of iron dextran among 481 patients and reported that 26 of patients experienced side effects of which the majority were mild and self. The dextran component of intravenous iron rather than iron itself.

Intravenous iron sucrose and sodium ferrous gluconate complex has proved to be well tolerated with significantly fewer serious adverse reactions than IV iron dextran. The adverse reactions that have occurred. Ferric gluconate and iron sucrose are newer forms of intravenous iron that were approved by the US.

Food and Drug Administration in 1999 and 2000 respectively. Rather than possessing a dense core of iron hydroxide as iron dextran does these agents have polynuclear iron. One formulation of parenteral iron is iron dextran which covers the old high molecular weight trade name DexFerrum and the much safer low molecular iron dextrans tradenames including Cosmofer and Infed.

Iron sucrose has an occurrence of allergic reactions of less than 1 in 1000.