Indications
Kidifer (Iron Sucrose) is indicated in the treatment of iron deciency anemia in the following patients:
• Where there is a clinical need for a rapid Iron supply.
• In patients who can not tolerate oral Iron therapy or who are non-compliant.
• Non-dialysis dependent-chronic kidney disease (NDD-CKD) patients receiving an erythropoietin.
• Non-dialysis dependent-chronic kidney disease (NDD-CKD) patients not receiving an erythropoietin.
• Hemodialysis dependent-chronic kidney disease (HDD-CKD) patients receiving an erythropoietin.
• Peritoneal dialysis dependent-chronic kidney disease (PDD-CKD) patients receiving an erythropoietin.
It is also indicated in the treatment of Iron deciency anaemia in patients undergoing surgical procedures, patients donating blood,
postpartum patients.
Dosage & Administration
The dosage of Kidifer (Iron Sucrose) is expressed in terms of mg of elemental iron. Each ml contains 20 mg of elemental iron. Most
CKD patients will require a minimum cumulative repletion dose of 1,000 mg of elemental iron, administered over sequential sessions,
to achieve a favorable hemoglobin response and to replenish iron stores (ferritin, TSAT). Hemodialysis patients may continue to
require therapy with Kidifer (Iron Sucrose) or other intravenous iron preparations at the lowest dose necessary to maintain target
levels of hemoglobin, and laboratory parameters of iron storage within acceptable limits. Kidifer (Iron Sucrose) must only be
administered intravenously either by slow injection or by infusion.
Recommended Adult Dosage:
Hemodialysis Dependent-Chronic Kidney Disease Patients (HDD-CKD)
Kidifer (Iron Sucrose) may be administered undiluted as a 100 mg slow intravenous injection over 2 to 5 minutes or as an infusion of
100 mg, diluted in a maximum of 100 ml of 0.9% Sodium Chloride over a period of at least 15 minutes per consecutive hemodialysis
session for a total cumulative dose of 1,000 mg.
Non-Dialysis Dependent-Chronic Kidney Disease Patients (NDD-CKD)
Kidifer (Iron Sucrose) is administered as a total cumulative dose of 1,000 mg over a 14 day period as a 200 mg slow IV injection
undiluted over 2 to 5 minutes on 5 dierent occasions within the 14 day period. There is limited experience with administration of an
infusion of 500 mg of Kidifer (Iron Sucrose), diluted in a maximum of 250 ml of 0.9% Sodium Chloride, over a period of 3.5-4 hours on
day 1 and day 14; hypotension occurred in 2 of 30 patients treated.
Peritoneal Dialysis Dependent-Chronic Kidney Disease Patients (PDD-CKD)
Kidifer (Iron Sucrose) is administered as a total cumulative dose of 1,000 mg in 3 divided doses, given by slow intravenous infusion,
within a 28 day period: 2 infusions of 300 mg over 1.5 hours 14 days apart followed by one 400 mg infusion over 2.5 hours 14 days
later. The Kidifer (Iron Sucrose) dose should be diluted in a maximum of 250 ml of 0.9% Sodium Chloride
Contraindications
The use of Kidifer (Iron Sucrose) is contraindicated in patients with evidence of iron overload, in patients with known hypersensitivity to Kidifer (Iron Sucrose) or any of its inactive components, and in patients with anemia not caused by iron deciency. Side Eects
The following possible side eects have been reported following the administration of Kidifer (Iron Sucrose): Temporary changes in taste (eg metallic taste), Nausea, stomach pain, diarrhea, vomiting, Muscle pain, cramps, Irregular heart beat,
Burning and swelling at injection site, Shivering, Fever, Tiredness, Itchy skin and rash.
Precautions
Iron Sucrose should be administered with caution in patients with asthma, eczema, other atopic allergies or allergic reaction to other
parenteral Iron preparations, low binding capacity and/or folic acid deciency, liver dysfunction, acute or chronic infection.
Baseline tests: Ensure Hgb, Hct, serum ferritin and transferrin saturation is determined before starting therapy and periodically during
treatment. Note that serum Iron levels may be reliably obtained 48 hours after IV dosing.
Blood Pressure: Monitor Blood Pressure during infusion. If hypotension occurs, slow the rate of infusion. If hypotension continues,
discontinue infusion and be prepared to treat appropriately.
Discontinue oral Iron preparations before administering parenteral Iron products. Co-administration of parenteral Iron preparations
may reduce absorption of oral Iron.The dose will be in terms of elemental Iron. For IV administration only. Not for intradermal,
subcutaneous, IM, or intra-arterial administration. Do not administer more than 3 times/week. IV infusion for elderly should be diluted
in 100 ml of 1 vial of 0.9% Sodium Chloride and should be infused over 15 minutes. Discard any unused diluted solution. Do not save
unused solution for future use. Do not administer if particulate matter or discoloration noted.
Drug Interactions
Drug-drug interactions involving Kidifer (Iron Sucrose) have not been studied. However, like other parenteral iron preparations, Kidifer (Iron Sucrose) may be expected to reduce the absorption of concomitantly administered oral iron preparations.
Use in Pregnancy and Lactation
Pregnancy Category B. Nursing Mothers: Kidifer (Iron Sucrose) is excreted in milk of rats. It is not known whether this drug is excreted
in human milk. Because many drugs are excreted in human milk, caution should be exercised when Kidifer (Iron Sucrose) is administered to a nursing woman.
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