Iron Dextran (Cosmofer) Dose Calculator

i) In pregnancy, use pre-pregnancy body weight.
ii) In obese patients (BMI > 30kg/m²), use Ideal Body Weight (IBW).

🔗 Refer to PRIC Newsletter (Cosmofer Quick Guide)

Formula: Calculated dose (mg) = Body Weight (kg) x (Target Hb - Current Hb) x 2.4
Note: For IDA, 500 mg has been added to the calculated dose.

📋 Step-by-Step Guide: How to Administer CosmoFer® (IV Iron Dextran) ▼
Step 1: Test Dose Preparation
  • Dilute 1 vial (100 mg) of CosmoFer in 100 mL of NS or D5.
Step 2: Test Dose Administration
  • Infuse 25 mg (= 25 mL) over 15 mins.
  • Observe for hypersensitivity reactions.
  • If no reaction occurs, administer the remaining portion (~75 mL) over 30 minutes.
Step 3: Total Dose Preparation & Administration
  • Dilute the rest of the calculated Cosmofer dose (up to 20 mg/kg) with ~500 mL NS or D5.
  • Administer over 4–6 hours (rate can be increased to 45-60 drops/min progressively).
📌 Interval Between Infusions for Multiple CosmoFer® Doses ▼

If calculated dose exceeds 20 mg/kg, divide and give on separate days.

Recommended interval: ➡️ ~1 week interval for every 600 mg of iron given.

Suggested Gap Between Infusions
First Infusion Wait Before Next Dose
600 mg ~1 week
1200 mg ~2 weeks
1800 mg ~3 weeks
💊 Can Oral Iron (eg Zincofer) Be Given Together with IV CosmoFer? ▼
Recommendation: ❌ Do not give oral iron concurrently with CosmoFer.
Why?
  • After IV iron, giving oral iron too soon is ineffective and may increase gastrointestinal side effects without benefit.
What to Do Instead:
  • Stop oral iron while CosmoFer is being administered.
  • Restart oral iron at least 5 days after the final CosmoFer dose.
  • After this interval, oral iron may be used at standard doses.