SODIUM FERRIC GLUCONATE COMPLEX

SODIUM FERRIC GLUCONATE COMPLEX
(so'di-um fer'ric glu'co-nate)
Ferrlecit
Classifications: blood former; iron preparation;
Therapeutic: antianemic; iron replacement

Prototype: Ferrous sulfate
Pregnancy Category: B

Availability

62.5 mg elemental iron/5 mL ampule

Action

Stable iron complex used to restore iron loss in chronic kidney failure patients. The use of erythropoietin therapy and blood loss through hemodialysis require iron replacement. The ferric ion combines with transferrin and is transported to bone marrow where it is incorporated into hemoglobin.

Therapeutic Effect

Effectiveness indicated by improved Hgb and Hct, iron saturation, serum ferritin levels.

Uses

Treatment of iron deficiency in patients on chronic hemodialysis and receiving erythropoietin therapy.

Contraindications

All anemias not related to iron deficiency; hypersensitivity to sodium ferric gluconate complex, benzyl alcohol; hemochromatosis, hemosiderosis; hemolytic anemia; thalassemia; neonates.

Cautious Use

Active or suspected infection; cardiac disease; hepatic disease; pregnancy (category B), lactation; older adults. Safety and efficacy in children <6 y are not established.

Route & Dosage

Iron Deficiency in Dialysis Patients
Adult: IV 125 mg infused over 1 h
Child (>6 y): IV 1.5 mg/kg infused over 1 h (max:125 mg/dose)

Administration

Intravenous

PREPARE: Direct for Adult: May be given undiluted.  IV Infusion for Adult/Child: Dilute 125 mg in 100 mL of NS. Use immediately after dilution.  

ADMINISTER: Direct for Adult: Give no faster than 12.5 mg/min.  IV Infusion for Adult/Child: Give over NOT less than 60 min.  

INCOMPATIBILITIES Solution/additive: Do not mix with any other medications or add to parenteral nutrition solutions.

  • Store unopened ampules at 20°–25° C (68°–77° F).

Adverse Effects (≥1%)

Body as a Whole: Hypersensitivity reaction (cardiovascular collapse, cardiac arrest, bronchospasm, oral/pharyngeal edema, dyspnea, angioedema, urticaria, pruritus). CV: Flushing, hypotension.

Pharmacokinetics

Not studied.

Nursing Implications

Assessment & Drug Effects

  • Monitor closely for S&S of severe hypersensitivity (see Appendix F) during IV administration.
  • Monitor vital signs periodically during IV administration (transient hypotension possible especially during dialysis).
  • Stop infusion immediately and notify physician if hypersensitivity is suspected.
  • Lab tests: Periodic Hgb, Hct, Fe saturation, serum ferritin.

Patient & Family Education

  • Report to physician immediately: Difficulty breathing, itching, flushing, rash, weakness, light-headedness, pain, or any other discomfort during infusion.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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