Iron Sucrose Injection [Elemental Iron]: Brands, Price & Uses in Bangladesh

Iron Sucrose Injection [Elemental Iron] is a parenteral (intravenous) iron replacement product used to treat iron-deficiency anemia in patients for whom oral iron is inadequate, not tolerated, or clinically inappropriate.

Established / Guideline-Supported Uses

• Iron-deficiency anemia in chronic kidney disease (CKD): The primary, well-established indication is treatment of iron-deficiency anemia in adult and pediatric patients (2 years and older) with chronic kidney disease, including patients on hemodialysis, peritoneal dialysis, and those who are not yet dialysis-dependent.

Other Guideline-Supported / Adjunct Uses

• Iron-deficiency anemia associated with inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease) when oral iron is not tolerated or ineffective.
• Correction of iron deficiency in patients with intolerance, malabsorption, or non-compliance with oral iron therapy.
• As an adjunct to erythropoiesis-stimulating agents (ESAs) in CKD-related anemia, where iron replacement supports an adequate response to ESA therapy.
• Selected pre-operative, post-partum, or heavy uterine bleeding-associated iron-deficiency states where rapid iron repletion is clinically indicated, per local (Bangladesh) prescribing practice.

Iron Sucrose Injection [Elemental Iron] is not indicated for anemias not caused by iron deficiency (e.g. hemolytic anemia, anemia of chronic disease without proven iron deficiency).

Iron Sucrose Injection [Elemental Iron] is dosed according to the calculated iron deficit and clinical indication, and is administered only by intravenous injection or infusion by a trained healthcare professional. It must never be given intramuscularly or self-administered by the patient at home.

Adult Dosing (Chronic Kidney Disease-Associated Iron-Deficiency Anemia)

Local prescribing practice in Bangladesh commonly describes adult dosing as 100–200 mg elemental iron, given one to three times weekly depending on hemoglobin level and calculated iron deficit, up to a maximum of 200 mg per single injection — this should be individualized by the treating physician based on the calculated total iron deficit.

Pediatric Dosing

In children 2 years of age and older with CKD-associated iron-deficiency anemia, the recommended dose is 0.5 mg/kg by slow IV injection or infusion, repeated as needed, not to exceed 100 mg per dose. Safety and efficacy in children under 2 years have not been established.

Renal/Hepatic Adjustment

No specific dose adjustment beyond the indication-based dosing above is well established for renal or hepatic impairment; Iron Sucrose Injection [Elemental Iron] is in fact the treatment for iron deficiency that commonly accompanies chronic kidney disease, and dosing already accounts for renal status per the schedules above. Use with caution in significant hepatic impairment, with close monitoring for iron overload.

Total cumulative dose should be calculated individually (e.g. using a body-weight/hemoglobin-deficit formula) and should not be exceeded, to avoid iron overload. See Contraindications and Precautions and Warnings.

Adverse effects associated with Iron Sucrose Injection [Elemental Iron] range from common, mild infusion-related symptoms to rare but serious hypersensitivity reactions.

Common

• Hypotension (transient, during or shortly after administration)
• Nausea, vomiting, diarrhea
• Headache, dizziness
• Muscle or leg cramps
• Injection-site reactions (pain, discoloration, swelling)
• Altered/metallic taste

Serious (Uncommon to Rare)

• Hypersensitivity reactions, including anaphylactic/anaphylactoid reactions with hypotension, bronchospasm, loss of consciousness, or collapse — see Precautions and Warnings.
• Significant hypotension requiring monitoring/intervention.
• Arthralgia, myalgia, chest pain (uncommon).

Patients should seek immediate medical attention for symptoms such as difficulty breathing, swelling of the face/throat, rash, or fainting.