Usual Adult Dose for Iron Deficiency Anemia

Hemodialysis Dependent Chronic Kidney Disease (HDD-CKD):
5 mL (100 mg elemental iron) undiluted, slow IV over 2 to 5 minutes
OR
5 mL (100 mg elemental iron) diluted in a maximum of 100 mL of 0.9% sodium chloride IV over at least 15 minutes
Total treatment course dose: 1000 mg.

• Administer early during the dialysis session; generally within the first hour

Non- Dialysis Dependent Chronic Kidney Disease (NDD-CKD):
10 mL (200 mg elemental iron), undiluted, IV over 2 to 5 minutes
OR
10 mL (200 mg elemental iron) diluted in a maximum of 100 mL of 0.9% sodium chloride IV over at least 15 minutes
Total treatment course dose: 1000 mg.

• Administer on 5 different occasions within a 14 day period to achieve a total cumulative dose of 1000 mg within the 14- day period.
• There is limited experience with administering 25 mL (500 mg elemental iron), diluted in a maximum of 250 mL of 0.9% sodium chloride, IV over 3.5 to 4 hours on days 1 and 14.

Peritoneal Dialysis Dependent Chronic Kidney Disease (PDD-CKD):
Two infusions of 15 mL (300 mg elemental iron) each, diluted in a maximum of 250 mL of 0.9% sodium chloride, IV over 90 minutes, 14 days apart

• Follow with one infusion of 20 mL (400 mg elemental iron), diluted in a maximum of 250 mL of 0.9% sodium chloride, IV over 2.5 hours, 14 days after second dose

Total treatment course dose: 1000 mg within a 28 day period.

Comments:

• Treatment may be repeated if iron deficiency recurs.

Use(s): Treatment of iron deficiency anemia in patients with chronic kidney disease (CKD)

Usual Pediatric Dose for Iron Deficiency Anemia

Dosing for iron REPLACEMENT TREATMENT in pediatric patients has not been established.

Iron MAINTENANCE treatment in patients 2 years and older:

Hemodialysis Dependent Chronic Kidney Disease (HDD-CKD):
0.5 mg elemental iron/kg (not to exceed 100 mg/dose) undiluted, slow IV over 5 minutes
OR
0.5 mg/kg (not to exceed 100 mg/dose) diluted to a concentration of 1 to 2 mg/mL in 0.9% sodium chloride IV over 5 to 60 minutes

• Administer every 2 weeks for 12 weeks
• Do not dilute to concentrations below 1 mg/mL

Non- Dialysis Dependent Chronic Kidney Disease (NDD-CKD) or Peritoneal Dialysis Dependent Chronic Kidney Disease (PDD-CKD) who are on erythropoietin therapy:
0.5 mg elemental iron/kg (not to exceed 100 mg/dose) undiluted, slow IV over 5 minutes
OR
0.5 mg/kg (not to exceed 100 mg/dose) diluted to a concentration of 1 to 2 mg/mL in 0.9% sodium chloride IV over 5 to 60 minutes

• Administer every 4 weeks for 12 weeks
• Do not dilute to concentrations below 1 mg/mL

Comments:

• Treatment may be repeated if necessary.

Use(s): Iron deficiency anemia in patients with chronic kidney disease (CKD)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the medication

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

See usual adult and pediatric dosing.

Other Comments

Administration advice:

• Administer only intravenously by slow injection or infusion.
• Dosage is expressed in mg of elemental iron; each mL contains 20 mg of elemental iron.

Storage requirements:

• Store at controlled room temperature; do not freeze

Reconstitution/preparation techniques:

• Do not dilute to concentrations below 1 mg elemental iron per milliliter.

IV compatibility:

• Do not mix with other medications or parenteral nutrition.