Brand Generic of ESAs and IV iron

Iron sucrose

Venofer

Lower risk of anaphylaxis than with dextran, higher rate of free iron reactions

For CKD GI -GS not receiving HD multiple patient visits are acquired because 1000 milligrams cannot be given in a single setting.

CKD: 5 doses of 200kg over 5 weeks

Low molecular weight

iron dextran

INFeD

25-mg test dose required 1 hr before administration of full dose (Important)

Often infused as single dose (975 mg) diluted in 250 mL NS infused over 1 hr (off-label)

Ferric gluconate

Ferrlecit

Lower risk of anaphylaxis than with dextran, higher rate of free iron reactions

Ferric carboxymaltose

Injectafer

May cause hypophosphatemia,

Ferric derisomaltose / iron isomaltoside

Monoferric

Ferumoxytol

Feraheme

Black box warning: Anaphylaxis

now SIO-mg intravenous infusion for 15 minutes with repeat in 3—8 days

Adverse drug reaction to i.v. iron therapy

Nonspecific symptoms:

STOP infusion

• Observe 15 minutes

• Restart if well at 25%-50% rate; STOP

Adverse drug reaction to i.v. iron therapy

Mild infusion reaction:

STOP infusion

• Observe

• Retrial after steroid or oral H, blocker (1 hr after treatment)

• Restart if well at 25%-50% rate if recurs, stop

Adverse drug reaction to i.v. iron therapy

Moderate reaction:

STOP

• Give i.v. fluids

• i.v. steroid 100 mg hydrocortisone

• H, blocker

• Restart if well at 25%-50% rate; if recurs. stop

Adverse drug reaction to i.v. iron therapy

Severe reaction:

STOP

Give i.v. fluids. 15 1 oxygen. 0.5 mg 1:1000 IMI adrenaline

Corticosteroid M (hydrocortisa--or methylprednisolone)

ß:-adrenoreceptor agonist, bronchodilator with nebulizer

• ADMIT= AVOID future use of Lv. iron

Epoetin alfa

Epogetin, Procrit

Darbepoetin

Aranesp