Parenteral Iron in Pregnancy : Indications and Dosage

 

1. Indications for parenteral iron

• Non compliant to oral iron therapy
• Hb level target not achieved despite maximum oral iron therapy
• Unable to tolerate oral iron therapy, due to side effects, etc
• When there is a need for rapid iron supply

2. Contraindications

• first trimester
• non iron deficiency anemia
• evidence of iron overload
• hypersensitivity reaction 

2. Dose calculation

• total dose iron (mg) = 

3. Types of parenteral iron

• Venofer 
• Content : iron (III) hydroxide sucrose complex
• Preparation : 20mg/ml of iron, 100mg per ampoule
• IV slow injection
• max dose 200mg/day, 3 times a week, 600mg/week
• IV infusion 
• max rate 7mg/kg (max dose 500mg), once a week
• Cosmofer
• Content : Iron Dextran
• Preparation 50mg/ml of iron, 100mg per ampoule
• IV infusion
• max dose 20mg/kg, given over 4-6 hours