Venofer
Venofer (iron sucrose) is an injectable iron supplement that's used to treat iron-deficiency anemia (IDA) in adults and children with chronic kidney disease (CKD). Venofer (iron sucrose) is given by a healthcare professional as an injection or infusion through the veins (IV). The dose depends on your age, your need for dialysis, and the type of dialysis you're having (either hemodialysis or peritoneal dialysis). Side effects include low blood pressure, headache, and nausea.
What is Venofer (iron sucrose)?
What is Venofer (iron sucrose) used for?
- Iron-deficiency anemia (low red blood cell count due to low iron levels) in people with chronic kidney disease
How Venofer (iron sucrose) works
Venofer (iron sucrose) is an iron supplement that helps replenish your body with this important mineral. Iron helps your bone marrow make red blood cells. It also helps make hemoglobin, a protein in red blood cells that's essential for delivering oxygen to different parts of your body.
Drug facts
Side effects of Venofer (iron sucrose)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults with CKD on hemodialysis:
- Low blood pressure (39%)
- Muscle cramps (29%)
- Nausea (15%)
- Headache (13%)
- Vomiting (9%)
- High blood pressure (7%)
- Dizziness (7%)
- Diarrhea (5%)
Children 2 years and older with CKD:
- Headache (6%)
- Viral respiratory tract infection (e.g., common cold; 4%)
- Swelling in stomach area (4%)
- Vomiting (4%)
- Fever (4%)
- Dizziness (4%)
- Cough (4%)
Less Common Side Effects
Adults with CKD on hemodialysis:
- Stomach pain
- Joint or back pain
- Chest pain
- Pain in arms or legs
- Swelling in arms, legs, or ankles
- Fever
- Cough
- Shortness of breath
- Respiratory tract infections
- Itching
Children 2 years and older with CKD:
- Nausea
- Changes in blood pressure
Note: Side effects might differ depending on your need for dialysis and the type of dialysis.
Venofer (iron sucrose) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- High iron levels: fatigue, weakness, darkening of skin color, stomach or joint pain
- Serious allergic reactions: chest pain, changes in heart rate, headache, dizziness, fever, rash, hives nausea, chills, flushing (feeling warm all of a sudden), fatigue, shortness of breath
The following Venofer (iron sucrose) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blurred vision
chest pain or tightness in the chest
confusion
difficult or labored breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
headache
nervousness
pounding in the ears
rapid weight gain
slow or fast heartbeat
sweating
tingling of the hands or feet
unusual tiredness or weakness
unusual weight gain or loss
Less common
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Change in taste
muscle cramps
nausea or vomiting
pain in the arms or legs
pain or burning sensation in the injection site
Less common
Abdominal or stomach pain
ankle, knee, or great toe joint pain
body aches or pain
chills
difficulty with moving
ear congestion or pain
flushed, dry skin
fruit-like breath odor
increased hunger or thirst
increased urination
lack or loss of strength
pain or redness at the injection site
pale skin at the injection site
unexplained weight loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Venofer (iron sucrose)
Pros
- Works well for treating iron-deficiency anemia
- Has relatively low risk of severe allergic reactions compared to other IV iron supplements
- Can be given as a shorter IV injection for some people
Cons
- Needs to be injected by a healthcare professional
- Requires multiple doses and office visits to complete treatment
- No lower-cost generic available; brand name only
Pharmacist tips for Venofer (iron sucrose)
- Mark your appointment(s) on your calendar to get your blood work done on time. The results from these blood tests help your prescriber check your iron levels during your treatment with Venofer (iron sucrose).
- During your infusion, tell a member of your care team right away if you experience dizziness, headache, trouble breathing, joint or muscle pain, or a tingling feeling. These can be signs that your Venofer (iron sucrose) injection is too fast. The healthcare professional can slow down how fast you're getting the medication through your IV. Your care team can also give you an antihistamine or steroid to help relieve these symptoms.
- You'll need to stay at the office or infusion center for at least 30 minutes after each Venofer (iron sucrose) dose. Your care team will check to see whether you have any allergic reactions to Venofer (iron sucrose). They can give you medications to treat these reactions, if needed.
- Don't take any other iron supplements while you're getting treated with Venofer (iron sucrose). This can put you at risk for having too much iron in the body, which can cause fatigue, weakness, darkening skin color, or joint pain.
- It's generally recommended that you follow an iron-rich diet to help restore your iron levels. Foods that are high in iron include red meats (like beef or pork), dark leafy greens (like broccoli or spinach), beans, and iron-enriched pasta and rice. Talk to your care team about how much iron you need to include in your diet every day.
Common questions about Venofer
Venofer gets quickly absorbed into your body and works quickly to help restore your iron levels. It takes about a day for ferritin levels to rise. Ferritin is a protein that stores iron in your body, so your ferritin levels help estimate how much iron you have in your body. In addition, it takes about a week for your transferrin saturation (TSAT) to rise. Transferrin is a protein that carries iron through your blood to various tissues in your body. As more iron attaches to transferrin proteins, your TSAT rises, which could mean your iron levels are starting to go back up. Contact your prescriber if you're concerned with how well Venofer is working for you.
It takes about 30 hours in adults and about 40 hours in children for Venofer to leave the body after a single dose. This time frame is estimated based on the half-life of the medication, or the time it takes for the medication's level in the body to drop by half.
It's not exactly clear how long Venofer side effects last. It might depend on the specific side effect you're experiencing. For example, side effects like nausea, vomiting, muscle cramps, and headache might get better over time. Let your care team know if you have any side effects during or after your Venofer dose. Also contact your care team if you still feel side effects even after you finish your Venofer treatment course. Your care team can recommend ways to manage and relieve the side effects.
Certain adults with chronic kidney disease (CKD) might be able to get Venofer daily until they reach their total recommended dose for their treatment course. This includes adults who don't need dialysis and adults who need hemodialysis. But adults with CKD who need peritoneal dialysis and children 2 years and older with CKD will need to follow a specific dosing schedule for their Venofer treatment. Your prescriber will make sure you get Venofer on the correct days and at the right dose. Keep in mind that you'll probably need to go to the medical office or infusion center for your Venofer treatment. Work with the medical office or infusion center to schedule your appointments.
There aren't clear recommendations on whether or not Venofer and a blood transfusion can be given together. Both are treatment options for iron-deficiency anemia. It's important to consider that blood transfusions provide iron. This means that it's possible for your iron levels to become too high if you take Venofer and get a blood transfusion together. Speak with your care team about whether it's appropriate for you to get a blood transfusion while you're getting treated with Venofer.
While iron supplements that are taken by mouth (like ferrous sulfate) are known to cause brown-colored urine, changes in urine color weren't reported by people who were treated with Venofer, an iron supplement that's injected through the vein. Seek medical help right away if you notice red- or dark-colored urine to get examined. This can be a sign of a medical problem, like bleeding or dehydration.
Both Venofer and Injectafer (ferric carboxymaltose) are iron supplements that are infused through the vein. They're both used to treat iron-deficiency anemia (IDA) in people with chronic kidney disease (CKD). But Injectafer can also be used for people who can't take iron supplements by mouth and for certain adults with heart failure and low iron levels. Another difference between both medications is the number of infusions you need to complete treatment. Depending on whether you need dialysis and the type of dialysis, you'll need 3 or more Venofer infusions for a complete treatment course. But with Injectafer, you typically only need 1 or 2 infusions. Studies show that both medications work just as well as each other to raise iron levels. Talk to your healthcare professional if you have more questions about comparing Venofer to Injectafer.
Studies show that iron infusions like Venofer are safe during the second and third trimesters of pregnancy to treat low iron levels. But it's unclear whether the medication is safe to use during the first trimester of pregnancy. It's important to know that untreated iron-deficiency anemia can cause problems during pregnancy. Discuss with your primary care provider about the risks and benefits of treatment with Venofer if you're pregnant or thinking of getting pregnant.
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Risks and warnings for Venofer (iron sucrose)
Venofer (iron sucrose) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious allergic reactions
- Risk factors: History of allergy to another iron product
Venofer (iron sucrose) can cause allergic reactions that can sometimes be serious and life-threatening, for example, anaphylaxis. Some symptoms of an allergic reaction are changes in blood pressure, fast heart rate, dizziness, rash, hives, difficulty breathing, throat tightness, and nausea. Your care team will keep an eye on you for allergic reactions for at least 30 minutes after the infusion. Seek medical help right away if you experience any symptoms of an allergic reaction.
Low blood pressure
Venofer (iron sucrose) can lower your blood pressure. This typically happens after the infusion. Your care team might check your blood pressure or monitor you for symptoms of low blood pressure, like lightheadedness or dizziness, after you get your infusion.
Too much iron in the body
Your care team will make sure that you get the right amount of IV iron supplementation that you need to treat your IDA. Too much iron in the body (iron overload) can be harmful. It can lead to liver, heart, and joint problems, as well as other organ damage.
To lower your risk for having too much iron in the body, don't take any other iron supplements during your treatment with Venofer (iron sucrose). Let your care team know right away if you experience fatigue, weakness, darkening skin color, or joint pain. These might be signs of high iron levels in your blood. Keep these signs in mind if your prescriber recommends that you take another iron supplement after you complete your treatment with Venofer (iron sucrose).
Venofer (iron sucrose) dosage
Typical dosage for Venofer (iron sucrose)
Venofer (iron sucrose) is given as an injection into the veins (intravenously or IV) by a trained healthcare professional.
Adults with CKD
- Who don't need dialysis: The typical total treatment is 1,000 mg, given as 5 doses of 200 mg IV over a two-week period. The medication is given as a slow injection over 2 to 5 minutes or as an infusion over 15 minutes.
- Who need hemodialysis: The typical total treatment is 1,000 mg, given as 10 doses of 100 mg IV per dialysis session. The medication is given as a slow injection over 2 to 5 minutes or as an infusion over 15 minutes.
- Who need peritoneal dialysis: The typical dose is 300 mg IV on day 1, 300 mg two weeks later, and then 400 mg after another two weeks. The medication is given as an infusion over 1.5 to 2.5 hours.
Children 2 years and older with CKD (for iron maintenance treatment)
- Who need hemodialysis: The dose will depend on your child's weight. The typical dose is 0.5 mg/kg of body weight (maximum 100 mg) IV every other week for 3 months. The medication is given as a slow injection over 5 minutes or as an infusion over 5 to 60 minutes.
- Who don't need dialysis OR who need peritoneal dialysis, but are taking erythropoietin-stimulating agents: The dose will depend on your child's weight. The typical dose is 0.5 mg/kg of body weight (maximum 100 mg) IV every month for 3 months. The medication is given as a slow injection over 5 minutes or as an infusion over 5 to 60 minutes.
You can repeat a treatment course with Venofer (iron sucrose), if needed.
Interactions between Venofer (iron sucrose) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Baloxavir Marboxil
- Bictegravir
- Dimercaprol
- Eltrombopag
- Erdafitinib
- Raltegravir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Delafloxacin
- Minocycline
- Mycophenolic Acid
- Zinc
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