Iron Sucrose (Venofer) | Ferumoxytol (Feraheme) | |
Dose (Max) | 300mg in 250mL NS | 510mg in 17mL (add to 50ml NS) |
Infusion Time | 2 hrs | 15-60 mins |
Serious Hypersensitivity | 0.6 per million | <5 in 1000 |
Cost | $120 | $200 |
Patients with the following risk factors should receive slower infusions (e.g. Feraheme® [ferumoxytol] over 60 minutes or Venofer® [iron sucrose] 300mg over 2 hours)
- Age > 65 yrs
- Baseline systolic BP less than 100
- Severe asthma or eczema
- Severe respiratory or cardiac disease
- Treatment with beta-blockers, ACE inhibitors or 3 or more anti-hypertensive medications
- Nephrology patients
After IV Iron, and with ongoing oral supplementation, a patient’s hemoglobin will start to rise 3-7 days. You can expect a 1-2 point rise in the hemoglobin per day, and after 2-4 weeks the hemoglobin will have risen 20-30g/L. Ferrous sulfate 300mg contains 60mg of elemental iron and 1 tab can be taken each night on an empty stomach at least 2 hours after meals with Vitamin C 500mg. Patients should also avoid taking with calcium or magnesium supplements as these decrease absorption.