Iron Sucrose

How it works

The iron-sucrose complex is taken up by the reticuloendothelial system, releasing iron that is incorporated into ferritin stores and transferrin for delivery to the bone marrow to support erythropoiesis.

Prescribing in practice

• Hypersensitivity and anaphylactoid reactions can occur with intravenous iron, so administer only where resuscitation facilities are available and observe the patient during and after the infusion.
• Avoid in the first trimester of pregnancy and use intravenous iron only when clearly required thereafter.
• Extravasation can cause persistent brown skin staining, so secure venous access and stop immediately if leakage is suspected.

Monitoring

Monitor for hypersensitivity during and after administration and reassess haemoglobin and iron indices (such as ferritin and transferrin saturation) to guide further dosing.

Counselling the patient

• Report any itching, rash, breathlessness, dizziness or facial swelling during the infusion at once.
• Mild flushing or muscle aches shortly after the dose can occur and usually settle.
• A repeat course or oral iron may be needed once stores recover.

Evidence & guidelines

Intravenous iron is recommended where oral iron is poorly tolerated or ineffective, including in chronic kidney disease, per NICE guidance.