Dosing & Administration

Below are Venofer® (iron sucrose) injection, USP dosing and administration instructions for adult and pediatric patients.

Adult CKD Patients1

The usual adult total treatment course of Venofer is 1000 mg. Venofer treatment may be repeated if iron deficiency reoccurs.

IV Push

100 mg over
2 to 5 min

  • Hemodialysis-dependent chronic kidney disease (HDD-CKD)
  • Consecutive dialysis sessions

200 mg over
2 to 5 min

  • Non-dialysis-dependent chronic kidney disease (NDD-CKD)
  • Five occasions over 14 days

Infusion*

Diluted with 0.9% Sodium Chloride Injection at concentrations of 1 to 2 mg/mL

100 mg/100 mL
over 15 min

  • Hemodialysis-dependent chronic kidney disease (HDD-CKD)
  • Consecutive dialysis sessions

200 mg/100 mL
over 15 min

  • Non-dialysis-dependent chronic kidney disease (NDD-CKD)
  • Five occasions over 14 days

2 doses of 300 mg/250 mL over 1.5 hrs
plus
1 dose of 400 mg/250 mL over 2.5 hrs

  • Peritoneal-dialysis-dependent chronic kidney disease (PDD-CKD)
  • 14 days apart

*Administer early during the dialysis session.

Pediatric CKD Patients1

Venofer treatment may be repeated if necessary. The dosing for iron replacement treatment in pediatric patients with hemodialysis-dependent chronic kidney disease (HDD-CKD), non-dialysis-dependent chronic kidney disease (NDD-CKD) or peritoneal-dialysis-dependent chronic kidney disease (PDD-CKD) has not been established.

Pediatric Patients

(2 years of age or older) with HDD-CKD

For iron maintenance treatment, administer Venofer

  • At a dose of 0.5 mg/kg, not to exceed 100 mg per dose
  • Every 2 weeks for 12 weeks
  • Given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at concentrations of 1 to 2 mg/mL and administered over 5 to 60 minutes

Pediatric Patients

(2 years of age or older) with NDD-CKD or PDD-CKD who are on erythropoietin therapy for iron maintenance treatment

For iron maintenance treatment, administer Venofer

  • At a dose of 0.5 mg/kg, not to exceed 100 mg per dose
  • Every 4 weeks for 12 weeks
  • Given undiluted by slow intravenous injection over 5 minutes or diluted in 0.9% NaCl at concentrations of 1 to 2 mg/mL and administered over 5 to 60 minutes

Venofer has not been studied in patients younger than 2 years old.

* Adapted from the KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Official Journal of the International Society of Nephrology. Kidney Int. 2012;2(4):288-335.

For adult CKD patients on ESA therapy who are not receiving iron supplementation, the guideline suggests a trial of IV iron (or in NDD-CKD patients, alternatively, a 1- to 3-month trial of oral iron therapy) if:

  • An increase in Hb concentration or a decrease in ESA dose is desired and
  • TSAT is <30% and ferritin is <500 ng/mL (<500 g/L)

CKD=chronic kidney disease
ESA=erythropoietin-stimulating agent
Hb=hemoglobin
IV=intravenous
RBC=red blood cell
WBC=white blood cell

REFERENCE

1. Venofer® [package insert]. Shirley, NY: American Regent, Inc.; 2019.