Name of the Procedure:

Injection, iron sucrose, 1 mg (HCPCS code: J1756)

Common name(s): Iron sucrose injection
Technical/medical term: Venofer (brand name), iron sucrose injection

Summary

Iron sucrose injection is a treatment used to address iron deficiency anemia. It involves administering iron directly into the bloodstream through an intravenous (IV) injection.

Purpose

Iron sucrose injection is utilized to:

• Treat iron deficiency anemia, particularly in patients with chronic kidney disease (CKD).
• Increase iron levels in the body to support the adequate production of red blood cells.
• Improve symptoms of fatigue, weakness, and pallor associated with iron deficiency anemia.

Indications

• Patients with iron deficiency anemia who have not responded adequately to oral iron supplements.
• Individuals with CKD on hemodialysis or peritoneal dialysis.
• Patients with non-dialysis-dependent CKD who require IV iron to manage anemia.

Preparation

• Patients may be instructed to hydrate adequately before the procedure.
• Certain medications may need to be adjusted; consult with the healthcare provider.
• No specific fasting is generally required for this procedure.
• A baseline blood test to measure iron levels and overall anemia status may be conducted.

Procedure Description

1. The patient is seated or lying down comfortably.
2. An intravenous (IV) line is inserted into a vein, typically in the arm.
3. Iron sucrose solution is administered slowly over a period of time, usually 15-60 minutes.
4. Vital signs are monitored throughout the infusion.
5. Post-infusion, the IV line is removed and the injection site is covered.

Tools and equipment:

• IV catheter
• Iron sucrose solution
• Infusion pump or manual IV administration set

Anesthesia or sedation: Not typically required.

Duration

The injection procedure usually takes about 15-60 minutes.

Setting

Iron sucrose injections can be performed in various settings, including:

• Outpatient clinic
• Hospital infusion center
• Dialysis center

Personnel

• Registered nurse (RN) or licensed practitioner administering the injection
• Physician or nurse practitioner overseeing the treatment plan

Risks and Complications

Common risks:

• Mild side effects such as nausea, headache, and dizziness
• Injection site reactions, including pain or bruising

Rare risks:

• Hypersensitivity or allergic reactions
• Hypotension (low blood pressure)

Possible complications:

• Management may involve stopping the infusion, administering antihistamines, or providing supportive care.

Benefits

• Improvement in iron levels and reduction of anemia-related symptoms.
• Enhanced quality of life and energy levels.
• Positive effects can be seen within a few days to weeks after the injection.

Recovery

• Minimal recovery time, patients can often resume normal activities shortly after treatment.
• Patients are advised to stay hydrated and report any severe side effects to their healthcare provider.
• Follow-up blood tests may be scheduled to monitor iron levels and anemia status.

Alternatives

• Oral iron supplements, which may be less effective in certain patients.
• Other IV iron formulations, with varying efficacy and side effect profiles.
• Blood transfusions in severe cases of anemia.

Pros and cons:

• Oral supplements are less invasive but may cause gastrointestinal side effects and be less effective.
• IV iron formulations are quick and effective but carry a risk of allergic reactions.

Patient Experience

During the procedure:

• Patients might feel a slight pinch from the IV insertion.
• Generally, the infusion is not painful, but some may experience mild discomfort.

After the procedure:

• Some may experience mild side effects such as a headache or dizziness.
• Pain management and comfort measures include applying a warm compress to the injection site and taking over-the-counter pain relievers if necessary.

Pain management:

• Inform the healthcare provider of any significant pain or discomfort during and after the injection for appropriate care and intervention.