Am J Health-Syst Pharm
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American Journal of Health-System Pharmacy, Vol. 65, Issue 2, 150-153
Copyright © 2008. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00

Notes

Evaluation of total-dose iron sucrose infusions in patients with iron deficiency anemia

 Geoffrey C. Wall and Rebecca A. Pauly

GEOFFREY C. WALL, PHARM.D., BCPS, CGP, is Internal Medicine Clinical Pharmacist, Iowa Methodist Medical Center (IMMC), Des Moines, and Associate Professor of Pharmacy Practice, Drake University, Des Moines. REBECCA A. PAULY, PHARM.D., is Critical Care. Pharmacist Specialist, Chandler Medical Center, AZ; at the time of writing she was Postgraduate Year-1 Resident, IMMC.

Address correspondence to Dr. Wall at the Department of Pharmacy, Iowa Methodist Medical Center, 1200 Pleasant Street, Des Moines, IA 50309 (geoff.wall{at}drake.edu).


Purpose. The safety and efficacy of a total-dose iron sucrose infusion protocol used in a large, tertiary care teaching hospital were studied.

Methods. Nondialysis-dependent patients ages 18 years or older who received ≥250 mg of iron sucrose as a single i.v. infusion between January 2005 and January 2007 were eligible for study inclusion. The protocol for total-dose iron sucrose infusion was the same for all patients. The total dose of iron sucrose for each patient was calculated using an equation that included the desired hemoglobin (Hb) value, observed Hb level, ideal body weight, and sex. The calculated dose was divided into portions, rounded to the nearest 250 mg, and administered over four hours every other day. Outcomes measured included Hb, transferrin saturation, and serum ferritin values.

Results. A total of 26 patients met the inclusion criteria. The mean ± S.D. Hb concentration before total-dose iron sucrose infusion was 9.37 ± 0.9 g/dL, and the mean ± S.D. corpuscular volume was 75 ± 7.1 µm3. The mean ± S.D. postinfusion Hb concentration for 19 patients for whom follow-up Hb levels were available was 11.4 ± 1.2 g/dL, significantly higher than the 9.45 ± 0.8 g/dL measured before the first infusion (p = 0.03). No significant adverse effects were reported in 47 of 49 infusions, with 2 patients experiencing mild nausea.

Conclusion. A treatment protocol consisting of alternate-day total-dose iron sucrose infusions was well tolerated and appeared to be effective in improving Hb concentrations in patients with iron deficiency anemia and without chronic kidney disease.

Index terms: Anemia; Dosage; Injections; Iron preparations; Iron sucrose; Toxicity

 





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