SODIUM FERRIC GLUCONATE COMPLEX
(so'di-um fer'ric glu'co-nate)
Ferrlecit
Classifications: blood formers, coagulators and anticoagulants; iron preparation
Prototype: Ferrous Sulfate
Pregnancy Category: B

Availability

62.5 mg elemental iron/5 mL ampule

Actions

Stable iron complex used to restore iron loss in chronic kidney failure patients. The use of erythropoietin therapy, and blood loss through hemodialysis requires iron replacement.

Therapeutic Effects

The ferric ion combines with transferrin and is transported to bone marrow where it is incorporated into hemoglobin. 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; hemochromatosis, hemosiderosis; hemolytic anemia.

Cautious Use

Active or suspected infection; pregnancy (category B), lactation; older adults. Safety and efficacy in children <18 y are not established.

Route & Dosage

Iron Deficiency in Dialysis Patients
Adult: IV 125 mg infused over 1 h

Administration

Intravenous

PREPARE: IV Infusion: Dilute 10 mL of Ferrlecit in 100 mL of NS. Use immediately after dilution.

ADMINISTER: IV Infusion: Give over NOT LESS than 60 min. Never administer at a rate greater than 2.1 mg/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.
Do not breast feed while taking this drug without consulting physician.

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