Capitalizing on strong industrial experience, we offer well formulated range of Yashifer (Iron Sucrose Injection). Our injection is brown in color and is an aqueous, complex of polynuclear Iron (III)-hydroxide in sucrose (Iron Sucrose) that can be used for intravenously. It has a molecular weight of approximately 34,000-60,000 daltons and each ml includes 20 mg elemental Iron as Iron Sucrose is water for injection. The dosage is available in 5 mL single dose ampoule (100 mg elemental Iron per 5 mL). It has 30% sucrose w/v (300 mg/mL) with a pH of 10.5-11.1. Yashifer is free from harmful preservatives and is extremely safe for health. It fulfills the required iron content in the body and increases RBC count. Additionally, it has Osmolarity is not less than 1150 and 1350 mOsmol/L.
Clinical pharmacology: |
Pharmacodynamics: |
- Following intravenous administration, iron sucrose is dissociated
by the reticuloendothelial system into iron and sucrose.
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Pharmacokinetics: |
- Following intravenous doses of iron sucrose, the iron component
exhibits first order kinetics with an elimination half-life of 5
hours, total clearance of 1.2L/h, non-steady state apparent volume
of distribution of 10.0L and steady state apparent volume of
distribution of 7.9 L. Since iron disappearance from serum depends
on the need for iron in the iron stores and iron utilizing tissues
of the body, serum clearance of iron is expected to the more rapid
in Iron deficient patients treated with Iron sucrose as compared to
healthy individuals. The effects of age and gender on the
pharmacokinetics of Iron Sucrose have not been studied.
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Distribution: |
- Following intravenous administration of Iron Sucrose, the iron
component appears to distribute mainly in blood to some extent in
extra vascular fluid. Significant amount of administered Iron is
distributed in the liver, spleen and bone marrow.
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Metabolism and elimination: |
- Following intravenous administration, Iron Sucrose dissociates
into iron and sucrose by the reticuloendothelial system. The sucrose
component is eliminated mainly by urinary excretion.
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Indications and usage: |
- Hemodialysis dependant chronic kidney disease (HDD-CKD) patients
receiving an erythropoietin
- Peritoneal dialysis dependant chronic kidney disease (PDD-CKD)
patients receiving an erythropoietin
- Non-dialysis dependant chronic kidney disease (NDD-CKD) patients
receiving or not an erythropoietin
- Other conditions where oral Iron therapy is considered inadequate
and parenteral iron therapy is indicated
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Dosage and administration: |
- The dosage of Iron sucrose is expressed in terms of mg of
elemental iron. Each mL contains 20 mg of elemental iron.
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Administration: |
- Iron sucrose must only be administered intravenously either by
slow injection or by Infusion.
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Hemodialysis dependant chronic kidney disease
patients (HDD-CKD): |
- The recommended dose of sucrose is 100 mg (5 mL) administered one
to three times per week, most patients will require a minimum
cumulative dose of 1000 mg over 10 sequential dialysis sessions.
Patients may continue to required therapy with iron sucrose at the
lowest dose necessary to maintain largest levels of haemoglobin,
hematocrit and laboratory parameters of iron storage within
acceptable limits.
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Slow Intravenous Injection: |
- In chronic kidney disease patients, iron sucrose may be
administered undiluted by slow intravenous injection into the
dialysis line at a rate of 1mL (20 mg Iron) solution per minute not
exceeding 5 mL of iron Sucrose (100 mg) per injection.
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Infusion: |
- Iron sucrose may be administered by infusion (into dialysis line
for hemodialysis patients). Infusion must be administered as every 5
mL Iron Sucrose diluted exclusively in a mixture of100 mL of 0.9%
NaCl, immediately prior to infusion. The solution must be infused at
the rate of 100 mg of iron over a period of at least 15 minutes.
Unused diluted solution must be discarded.
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Non-dialysis dependant chronic kidney disease
patients (NDD-CKD): |
- Iron Sucrose is administered as total cumulative doses of 1000 mg
over a 14 day period as a 200 mg slow IV injection undiluted over 2
to 5 minutes on the 5 different occasions within 14 day period.
There is limited experience with administered of an infusion of 500
mg Iron Sucrose, diluted in a maximum of 250 mL of 0.9% NaCl, over a
period of 3.5 - 4 hours on 1 and 14.
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Peritoneal dialysis dependant chronic kidney
disease patients (NDD-CKD): |
- Iron sucrose is infused intravenously in three divided doses for
a total dose of 1000 mg during a 28-day period: two infusions of 300
mg over 1.5 hours 14 days apart, followed by one 400-mg infusion
over 2.5 hours 14 days later.
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Note: |
- Do not mix Yashifer with other medications or add to parenteral
nutrition solutions for intravenous infusion. Parenteral drug
products should be inspected visually for particulate matter and
discoloration prior to administration, whenever the solution and
container permit.
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SIDE EFFECTS: |
- Side effects include hypotension, chest pain, hypertension,
hypervolemia, CHF, cramps, musculoskeletal pain, diarrhea, nausea,
vomiting, abdominal pain, elevated liver enzyme, skin irritation,
pruritis, application site reaction, dizziness, dysprea, pneumonia,
cough, headache, fever, asthenia, malaise
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Drug interaction: |
- Iron sucrose should not be administered concomitantly with oral
iron preparations since the absorption of oral iron is reduced.
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Warning: |
- Hypersensitivity reactions have been reported with injectable
iron products.
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Precautions: |
General: |
- Because body iron excretion is limited and excess tissue iron can
be hazardous, caution should be exercised to withhold iron
administration in presence of evidence of tissue iron overload.
Patients receiving iron sucrose requires periodic monitoring of
hematologic and hematinic parameters. Iron therapy should be
withheld in patients with evidence of iron over load transferrin
saturation values increase rapidly after IV administration of iron
sucrose; serum iron values may be reliably obtained 48 hours after
IV dosing.
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Hypersensitivity reactions: |
- Serious hypersensitivity reactions have been rarely reported in
patients receiving Iron Sucrose.
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Hypotension: |
- Hypotension has been reported in chronic kidney disease patients
receiving intravenous iron. Hypotension following administration of
Iron sucrose may be related to rate of administration and total dose
administered. Caution should be taken to administer Iron sucrose
according to recommended guidelines.
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Carcinogenesis, mutagenesis and impairment of
fertility: |
- No long term studies in animals have been performed to evaluate
the carcinogenic potential of iron sucrose.
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Pregnancy category B: |
- No adequate and well controlled studies in pregnant woman have
been reported because animal reproduction studies are not always
predictive of human response, this drug should be used during
pregnancy only if clearly needed.
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Nursing mothers: |
- It is not known whether this drug is excreted in human milk.
Because many drugs are excreted in human milk, caution should be
exercised when Iron sucrose is administered to a nursing woman.
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Pediatric use: |
- Safety and effectiveness of iron sucrose in patients have not
been established.
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Geriatric use: |
- There are no identified differences in responses between elderly
and younger patients, but greatly sensitivity of some of the older
individuals cannot be ruled out. Strict aseptic administration shall
be followed.
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Caution: |
- Before using check for absence of sediments. The injection should
be discarded if any visible particles appear.
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Overdose: |
- Dosages of Iron sucrose in excess of iron needs may lead to
accumulation of iron in storage site leading to hemosiderosis.
Periodic monitoring of iron parameters such as serum ferritin and
transferrin saturation may assist in recognizing iron accumulation.
Iron sucrose should not be administered to patients with iron
overload and should be discontinued when serum ferrin levels equal
or exceed established guidelines. Particular caution should be
exercised to avoid iron overload where anemia unresponsive to
treatment has been incorrectly diagnosed as iron deficiency anemia.
Symptoms associated with over dosage or infusing Iron sucrose to
rapidly included hypotension, dyspnoea, headache, vomiting, nausea,
dizziness, joint aches, paresthesia, abdominal and muscle pain,
edema and cardiovascular collapse. Most symptoms have been
successfully treated with IV fluid, hydrocortisone and/or
antihistamines. Infusing the solution as recommended or at a slower
rate may also be alleviating symptoms.
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Contraindications: |
- The use of iron sucrose is contraindicated in patients with
evidence of iron overload, in patients with known hypersensitivity
to it or any of its inactive components, and in patients with anemia
not caused by iron deficiency.
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Presentation: |
- Pack of 5 ampoules in a tray
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Storage: |
- Store at controlled room temperature between 20℃ to 25℃
- Do not freeze
- Keep out of reach of children
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