Iron sucrose inj

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Children < 14 kg: 1.5 mg/kgLocationIn-patient pharmacy: warded patients; Kedai PharmUMMC: outpatient.Administration IM injection: NASC injection: NAIV injection: Slow injection or directly into the venous limb of the dialyser. Administer ata rate of 1 mL undiluted solution over minute (i.e. 5 min per 5 mL ampoule) not exceeding10mL iron sucrose per injection. After injection, extend the arm of the patient.IV infusion: Each mL (20 mg) of iron sucrose has to be diluted exclusively in maximumof 20 mL 0.9% w/v NaCl, immediately prior infusion and infused at a rate of : 100mL (100mg) in at least 15 min ; 200 mL (200mg) in at least 30 min ; 300 mL in at least 1.5 h ; 400mL in at least 2.5 h ; 500mL in at least 3.5h. For stability reasons, dilution of lowerconcentrations are not permissible. If clinical circumstances demand, iron sucrose may bediluted in less than specified amount of 0.9% w/v NaCl solution, producing a higherconcentration. The rate of infusion must be adapted according to the amount of iron givenper minute (200mg iron should be infused in at least 30 minutes ; 500 mg iron should beinfused in at least 3.5h).Intrathecal: NAIntraperitoneal: NAStability / expiry Reconstituted solution: Stable at controlled room temperature for 12 hours if storedbetween 4-25°C in the day light.Undiluted solution: Store a controlled room temperature of 4 to 25°CCompatibility Compatible fluids: NSCompatible drugs: NACompatible via Y site: NACompatible in syringe: NAIncompatibility Incompatible fluids: NAIncompatible drugs: Oral iron preparationSpecial precautions • Should only be administered where the indication is confirmed by appropriateinvestigations (e.g. serum ferritin, haemoglobin, haematocrit, erythrocyte count or redcell indices – MCV, MCH, MCHC).• Parenterally administered iron preparations can cause allergic or anaphylactoidreactions, including serious or life-threatening reactions. Patients with bronchialasthma, with low iron binding capacity and/or folic acid deficiency are particularly atrisk of an allergic or anaphylactic reaction.• Before administration of the 1 st therapeutic dose of iron sucrose in a new patient, a testdose should be given by the chosen method of administration with facilities forcardiopulmonary resuscitation being made available. If no adverse reactions occur
within 15 min after administration, the remaining portion of the initial dose can begiven• Hypotension has been reported frequently in hemodialysis dependent patients.• Used during pregnancy only if clearly needed. Caution during lactation.• Safety and efficacy in children have not been established.• Should not be administered concomitantly with oral iron preparations since theabsorption of iron is reduced. Oral iron therapy should at least be started 5 days afterthe last injection.• Overdosage can cause acute iron overloading which may manifest as haemosiderosis.Symptoms: hypotension, headache, vomiting, nausea, dizziness, joint aches,parasthesia, abdominal and muscle pain, oedema and cardiovascular collapse. Treatedwith supportive measures (IV fluids, hydrocortisone, and/or antihistamines) and, ifrequired, an oral chelating agent.Special notes • Stock from Inpatient pharmacy is for inpatients only.• Outpatients are required to purchase from Kedai PharmUMMCPatient information • Side effects: hypotension (caution when driving or climbing stairs); black tarry stools(normal), nausea, vomiting (taking with meals with reduce this), constipation(adequate fluids and exercise may help, may need a stool softener); or diarrhea(buttermilk, boiled milk or yogurt may help).• Report severe unresolved GI irritation (cramping, nausea, vomiting, diarrhea,constipation); headache, lethargy, fatigue, dizziness or other CNS changes; rapidrespiration; leg cramps’ chest pain or palpitations; swelling of extremities orunexplained weight gain; vision changes; choking sensation; loss of consciousness; orconvulsion.Prepared/checked by Yeap Li Ling / PDS / HKD / PLDate compiled/edition 20 July 2009, 1 st edition
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Iron sucrose inj

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