Ferric Gluconate
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Trade Name
Ferrlecit (primary brand name); generic ferric gluconate
Classification
Iron supplement; parenteral iron preparation
Dosage/Route
- * Dosage: Available as 62.5 mg/5 mL (12.5 mg/mL elemental iron) in single-dose vials
- * Route: Intravenous (IV) infusion or slow IV injection
Usual Dosage
- * Adults (dialysis patients): 125 mg (10 mL) IV per dialysis session; typical course is 8 doses (total 1 g)
- * Test Dose: 2 mL (25 mg) diluted in 50 mL saline, infused over 60 minutes to check for hypersensitivity (often per protocol)
- * Non-dialysis: May vary (e.g., 62.5-125 mg IV weekly), based on iron deficit
Mechanism of Action
Provides elemental iron to replenish iron stores, supporting hemoglobin synthesis in red blood cells. Iron is incorporated into ferritin and transferrin, correcting anemia by aiding oxygen transport
Side Effects & Adverse Effects
- * Side Effects: Hypotension, nausea, cramps, headache, flushing.
- * Adverse Effects:
- – Hypersensitivity reactions (e.g., anaphylaxis—rare but serious).
- – Iron overload (if over-administered; symptoms: hemosiderosis, organ damage).
- – Infusion reactions (chest pain, dyspnea)
Nursing Management (Implications & Teachings)
- * Implications:
- – Administer test dose first; monitor for 30-60 minutes for reactions
- – Watch vital signs during infusion (hypotension risk)
- – Dilute in 100 mL saline and infuse over 60 minutes (or per protocol); avoid rapid push
- – Assess labs: hemoglobin, ferritin, transferrin saturation to guide therapy
- * Teachings:
- – Expect temporary flushing or warmth during infusion
- – Report difficulty breathing, rash, or chest pain immediately
- – Avoid taking oral iron concurrently (IV bypasses GI absorption)
- – Follow-up bloodwork needed to monitor response
Indication for This Patient
- * Iron deficiency anemia in patients unable to tolerate/absorb oral iron (e.g., chronic kidney disease on hemodialysis)
- * Adjunct to erythropoietin therapy in dialysis patients to boost red blood cell production
Time
- * Timing: Given during hemodialysis sessions (typically 2-3 times/week) or as scheduled IV for non-dialysis patients
- * Infusion Time: 125 mg over 60 minutes (after dilution); test dose slower (e.g., 60 minutes)
- * Onset: Hemoglobin rise may take days to weeks with repeated doses
