ENCIFER INJECTION

💉 Iron Sucrose Injection 100mg/5ml – A Detailed Overview 🩸

Introduction:
Iron Sucrose Injection (100mg/5ml) is a parenteral iron formulation used for the treatment of iron deficiency anemia (IDA), particularly in patients with chronic kidney disease (CKD). It delivers iron directly into the bloodstream, bypassing the gastrointestinal tract, making it especially useful for patients who cannot tolerate or absorb oral iron supplements effectively.

📦 Composition and Presentation

Each 5ml vial contains 100mg of elemental iron as iron sucrose complex. The solution is typically dark brown, sterile, and non-pyrogenic, and it’s available in single-dose vials for intravenous use.

🧪 Mechanism of Action

Iron sucrose is a complex of polynuclear iron(III)-hydroxide in sucrose. After administration, the complex is taken up by the reticuloendothelial system (especially in the liver, spleen, and bone marrow), where iron is gradually released and incorporated into hemoglobin and other iron-containing proteins. This mechanism ensures a controlled release of iron and minimizes the risk of free iron toxicity.

🏥 Indications

• Iron Deficiency Anemia in adults and pediatric patients (≥2 years old) with:

  • Chronic Kidney Disease (CKD) on hemodialysis or peritoneal dialysis

  • CKD not on dialysis

• Patients who have intolerance to oral iron or inadequate response to oral therapy

• Post-operative or peripartum iron deficiency (off-label but commonly practiced)

💉 Dosage and Administration

• IV injection or IV infusion only; not for intramuscular use.

• The standard adult dose is 100mg elemental iron per administration, given 1 to 3 times a week, depending on hemoglobin levels and iron status.

• Must be administered slowly over 2 to 5 minutes if given as a direct injection, or diluted in 100ml of 0.9% sodium chloride and infused over at least 15 minutes.

• Total cumulative dose should be calculated based on body weight and hemoglobin deficit.

⚠️ Warnings and Precautions

• Risk of hypersensitivity reactions, including anaphylaxis—resuscitative equipment should be available.

• Monitor for hypotension, especially in patients with volume depletion.

• Not recommended for use in the first trimester of pregnancy unless absolutely necessary.

• Use caution in patients with active infections, as iron may promote microbial growth.

🚫 Contraindications

• Known hypersensitivity to iron sucrose or its components

• Non-iron deficiency anemia (e.g., hemolytic anemia)

• Evidence of iron overload (e.g., hemochromatosis)

🤒 Adverse Effects

• Common: Nausea, headache, dizziness, injection site reactions, hypotension

• Less common but serious: Anaphylactic-type reactions, chest pain, arrhythmia

• Typically well-tolerated when administered correctly under supervision.

🧾 Monitoring Parameters

• Hemoglobin and hematocrit levels

• Serum ferritin and transferrin saturation (TSAT)

• Monitor for signs of hypersensitivity and hypotension during and after administration

🛡️ Storage and Handling

• Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F)

• Do not freeze or shake

• Protect from light; use immediately after opening

Conclusion:
Iron Sucrose Injection 100mg/5ml is a vital therapeutic option for managing iron deficiency anemia, especially in patients with CKD. Its targeted delivery system allows for effective replenishment of iron stores with a lower risk of adverse effects compared to older IV iron formulations. However, administration should be monitored carefully to mitigate potential risks.