Names and pronunciation
Velphoro, Venofer
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Individual generic drug information
Extracted information for iron sucrose only.
Velphoro, Venofer
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Func. class.: Hematinic
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Chem. class.: Ferric hydroxide com- plex with dextran
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ACTION: Iron is carried by transferrin to the bone marrow, where it is incorpo- rated into hemoglobin
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USES: Iron-deficiency anemia, hyper- phosphatemia in chronic kidney disease on dialysis
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Unlabeled uses: Dystrophic epider- molysis bullosa (DEB)
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Extracted information for iron sucrose only.
CONTRAINDICATIONS: Hyper- sensitivity, all anemias excluding iron- deficiency anemia, iron overload Precautions: Pregnancy, breastfeeding, children, geriatric patients, abdominal pain, anaphylactic shock, arthralgia, chest pain, cough, diarrhea, dizziness, dyspnea, edema, increased LFTs, fever, headache, heart fail- ure, hypo/hypertension, infection, MS pain, nausea/vomiting, seizures, weakness
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SIDE EFFECTS CNS: Headache, dizziness CV: Chest pain, hypo/hypertension, hypervolemia, heart failure GI: Nausea, vomiting, abdominal pain INTEG: Rash, pruritus, urticaria, fever, sweating, chills OTHER: Anaphylaxis, hyperglycemia RESP: Dyspnea, pneumonia, cough
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INTERACTIONS Increase: toxicity—oral iron, dimercap- rol; do not use Decrease: iron sucrose effect—chlor- I amphenicol Drug/Lab Test Increase: glucose
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TREATMENT OF OVERDOSE: Discontinue product, treat allergic reac- tion, give diphenhydrAMINE or EPINEPH- rine as needed, give iron-chelating prod- uct for acute poisoning
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Extracted information for iron sucrose only.
DOSAGE AND ROUTES • Adult: IV 5 mL (100 mg of elemental iron) given during dialysis; most will need 1000 mg of elemental iron over 10 sequential dialysis sessions • Child ≥2 yr/adolescents: IV 0.5 mg/kg by slow IV inj over 5 min (undiluted) or diluted in 25 mL of 0.9% NaCl, give over 5-60 min, max 100 mg every 2 wk × 12 wk Hyperphosphatemia in chronic kidney disease • Adult: PO 500 mg tid with meals
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Available forms: Inj 20 mg/mL; chew tab 500 mg
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Administer: PO route • Give with meals • Do not crush or chew • Only with EPINEPHrine, SOLU-Medrol available in case of anaphylactic reaction during dose IV route • Do not use if particulate is present or if discolored • Give directly in dialysis line by slow inj or infusion; give by slow inj at 1 mL/min (5 min/vial); for infusion, dilute each vial ex- clusively in ≤100 mL 0.9% NaCl, give at 100 mg of iron/15 min; discard unused portions • Do not use with IV products • Store at room temperature in cool en- vironment; do not freeze
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Extracted information for iron sucrose only.
Assess: • Blood studies: Hct, HB, reticulo- cytes, transferrin, plasma iron concen- trations, ferritin, total iron binding; bilirubin before treatment, at least monthly • Allergy, anaphylaxis: rash, pruritus, fever, chills, wheezing; notify prescriber immediately, keep emergency equipment available • Cardiac status: hypo/hypertension, hy- pervolemia • Toxicity: nausea, vomiting, diarrhea, fever, abdominal pain (early symptoms), cyanotic-looking lips, nailbeds, seizures, CV collapse (late symptoms) • Pregnancy/breastfeeding: use only if clearly needed; cautious use in breast- feeding
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Evaluate: • Therapeutic response: increased se- rum iron levels, Hct, HB
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report itching, rash, chest pain, head ache, vertigo, nausea, vomiting, abdominal pain, joint/muscle pain, numbness, tingling • That iron poisoning may occur if dos age is increased beyond recommended level; not to take oral iron preparation
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Extracted information for iron sucrose only.
PHARMACOKINETICS Excreted in urine, half-life 6 hr
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Filter the extracted dose blocks for this individual drug.
• Adult: IV 5 mL (100 mg of elemental iron) given during dialysis; most will need 1000 mg of elemental iron over 10 sequential dialysis sessions
Candidate age grouping · source page 723
• Adult: PO 500 mg tid with meals
Candidate age grouping · source page 723