Iron Sucrose is a parenteral iron preparation consisting of a polynuclear iron(III)-hydroxide core stabilized by a sucrose shell, forming a complex with a molecular weight of approximately 34,000–60,000 Da. It is used for the rapid correction of iron deficiency anemia (IDA) in patients where oral iron is ineffective, not tolerated, or where a rapid replenishment of iron stores is clinically required. It is a colloidal solution for intravenous administration.
Adult: Dose is calculated based on body weight and hemoglobin deficit. Formula: Total iron deficit (mg) = Body weight (kg) x (Target Hb - Actual Hb) (g/dL) x 2.4 + Iron stores (500 mg). For simple iron deficiency, a common regimen is 100-200 mg (5-10 ml) per dose, administered 1-3 times per week until the total cumulative dose is reached. Maximum single dose: 200 mg (10 ml). Maximum weekly dose: 600 mg.
Note: For IV Injection (Slow): 100-200 mg (5-10 ml) undiluted, administered at a rate of 1 ml (20 mg) per minute. For IV Infusion: Dilute 100-500 mg (5-25 ml) in a maximum of 250 ml of 0.9% Sodium Chloride. Infuse over at least 15 minutes (for 100 mg) to 3.5-4 hours (for 500 mg). Do not mix with other medications or parenteral nutrition solutions. Observe patient for at least 30 minutes after administration for hypersensitivity reactions.
Iron Sucrose delivers bioavailable iron directly into the intravascular space, bypassing the gastrointestinal absorption barrier. The complex is designed to be stable, minimizing the release of free, toxic ionic iron into the circulation. It is phagocytosed by macrophages of the reticuloendothelial system (RES). Within the macrophages, the sucrose ligand is enzymatically cleaved, releasing iron into the intracellular labile iron pool. This iron is then either stored as ferritin or released into the plasma bound to transferrin, the physiological iron transport protein. Transferrin-bound iron is delivered to erythroid precursor cells in the bone marrow for incorporation into hemoglobin.
Pregnancy: Category B: Animal studies have not shown risk, but adequate and well-controlled studies in pregnant women are lacking. Should be used only if clearly needed, preferably in the second or third trimester for severe, refractory IDA. Benefit must outweigh potential risk.
Driving: May cause dizziness or hypotension. Patients should be cautioned not to drive or operate machinery until they know how the medication affects them, particularly after an infusion.
| Oral Iron Supplements | Concurrent use is unnecessary and may increase risk of gastrointestinal side effects without added benefit. | Moderate |
| Angiotensin-Converting Enzyme (ACE) Inhibitors (e.g., Enalapril, Ramipril) | May potentiate the risk of systemic reactions to parenteral iron. | Moderate |
| Dimercaprol | Chelating agent; may form a toxic complex with iron. Contraindicated in iron overload from parenteral iron. | Major |
| Chloramphenicol | May delay the hematologic response to iron therapy by inhibiting erythroid maturation. | Moderate |
Same composition (Iron Sucrose (100mg/5ml)), different brands: