DRUG SUPPLIED DOSE COMMENTS
FERRIC DERISOMALTOSE (Paeds)
(Iron Isomaltoside, Monoferric)

Mechanism of action:

Intravenous iron supplementation - see comments for indications.



Ref: 587


Last update: 2022-07-04		 injection:  100 mg/mL elemental Fe;

1mL, 5mL,  10mL vials

 Note: Sodium ferric gluconate (Ferrlecit) is the iron of choice in the chronic kidney disease population.

Treatment of iron deficiency:
1. Calculate total iron deficit:
Patients <= 35 kg:    
Total iron deficit (mg) = [body weight (kg) x (130 g/L - Hb (g/L)) x 0.24] + 15 mg/kg
Where 130 g/L = target haemoglobin level, and 15 mg/kg = depot iron

Patients > 35 kg:     
Total iron deficit (mg) = [body weight (kg) x (150 g/L -  Hb (g/L)) x 0.24] + 500 mg
Where 150 g/L = target haemoglobin level, and 500 mg = depot iron

Round dose to nearest 100 mg

2. Maximum dose is 20 mg/kg (up to 1000 mg).  If the total iron deficit exceeds the maximum daily dose, the total dose must be divided and given separated by at least 1 week until the total amount has been administered.

 Risk of hypersensitivity reactions is approximately 1%.
Test doses are not required.
Round dose to nearest 100 mg.
See Parenteral Manual for monitoring guidelines.

RESTRICTED for use in patients with:
1. Indications outlined by BC Renal AND patients who are registered with BC Renal OR
2. intolerance or poor response to oral iron supplements OR
3. gastrointestinal malabsorption syndrome (for example inflammatory bowel disease, active Celiac disease, atrophic gastritis) AND
4. hemoglobin less than 110 g/L AND ONE OF
    ferritin less than 30 mcg/L OR
    ferritin less than 200 mcg/L with iron saturation less than 20%
AND
4. total dose required exceeds 300 mg IV iron elemental AND
5. patients weighing at least 30 kg



Standard Prescription:

Ferric Derisomaltose __ mg ( __ mg/kg) IV over __ minutes {frequency}