FEROSAC IV is an intravenous solution containing iron sucrose, specifically formulated for the treatment of iron deficiency anemia. Each ampoule contains 100 mg of iron in a 5 ml volume. This formulation is commonly used in patients with chronic kidney disease (CKD), particularly those undergoing dialysis, or in individuals who cannot tolerate or do not respond adequately to oral iron supplements. The intravenous administration of iron sucrose allows for more efficient and direct replenishment of iron levels in the body, offering an effective solution for patients who require rapid correction of anemia.

Pharmaceutical Properties:

• Active Ingredient: Each ampoule contains 100 mg of iron sucrose.

• Appearance: The solution is typically a clear to slightly brown liquid, free from visible particulates.

• Pharmacokinetics: Upon administration, iron sucrose is absorbed into the bloodstream. The iron is transported by transferrin to the bone marrow, where it is incorporated into hemoglobin. The remainder of the iron is stored in the liver, spleen, and bone marrow.

• Solubility: The solution is water-soluble and should be administered intravenously. It is not intended for oral administration or intramuscular injection.

• Stability: The solution should be stored at controlled room temperature, away from direct sunlight, and used within the recommended time frame once opened.

Mechanism of Action:

FEROSAC IV works by providing elemental iron, which is essential for the formation of hemoglobin in red blood cells. Once administered intravenously, iron sucrose is broken down in the bloodstream, releasing ferric ions that bind to transferrin, the plasma protein that transports iron. This bound iron is then directed to the bone marrow, where it is used for the production of hemoglobin and red blood cells. By replenishing the body’s iron stores, FEROSAC IV corrects the deficiency that causes anemia, improving oxygen transport and energy levels.

Other Characteristics:

• Indications: The primary indication for FEROSAC IV is the treatment of iron deficiency anemia, especially in patients with chronic kidney disease, those undergoing dialysis, or those unable to absorb or tolerate oral iron supplements.

• Contraindications: It is contraindicated in patients with known hypersensitivity to iron sucrose or any of its components. It is also not suitable for patients with iron overload conditions, such as hemochromatosis.

• Adverse Effects: Common side effects may include headache, abdominal discomfort, nausea, dizziness, and low blood pressure. More serious reactions could involve allergic responses, including anaphylaxis.

• Dosage and Administration: The usual dose is 100 mg (5 ml) administered intravenously. The dose may be repeated depending on the clinical response and the patient's serum iron levels.

• Precautions: FEROSAC IV should be used with caution in patients with cardiovascular disease, uncontrolled hypertension, or a history of hypersensitivity to iron preparations. Patients should be closely monitored during and after the infusion.

Clinical Protocol in Dubai:

1. Patient Selection:
   FEROSAC IV is recommended for patients with iron deficiency anemia, particularly those with chronic kidney disease (CKD) or undergoing dialysis, who require immediate iron supplementation or who cannot tolerate oral iron. It should not be used in patients with iron overload or those allergic to iron sucrose.

2. Dosage and Administration:

   • Initial Dose: 100 mg (5 ml) should be administered intravenously.

   • Repeat Doses: Depending on the clinical condition and iron studies, additional doses may be required to reach desired iron levels.

   • Administration Method: The solution should be administered slowly through an intravenous infusion over 2-5 minutes. It is important to monitor the patient during infusion to detect any adverse reactions.

3. Monitoring:

   • Before treatment, assess baseline hemoglobin, ferritin, and transferrin saturation.

   • Monitor vital signs (especially blood pressure and heart rate) during the infusion process.

   • After the administration, regular follow-ups should be conducted to assess improvement in hemoglobin levels and iron stores, and avoid potential iron overload.

4. Precautions:

   • Hypersensitivity: Patients with known allergies to iron preparations should be closely monitored.

   • Iron Overload: Avoid in patients with conditions such as hemochromatosis that involve iron overload.

   • Cardiovascular Conditions: Administer with caution in patients with cardiovascular diseases or uncontrolled hypertension, as infusion may cause transient hypotension.

Conclusion:

FEROSAC IV is a highly effective intravenous solution used to treat iron deficiency anemia, particularly in patients with chronic kidney disease or those who are unable to tolerate oral iron supplements. It offers rapid replenishment of iron, which is crucial for hemoglobin production and improved oxygen delivery to tissues. However, its use should be closely monitored to avoid complications such as iron overload or hypersensitivity reactions. When administered correctly and under appropriate clinical supervision, FEROSAC IV can significantly improve the quality of life for individuals suffering from iron deficiency anemia.