iron dextran

Contraindicated in:

Anemia not due to iron deficiency;
Hemochromatosis;
Hemosiderosis;
Hypersensitivity to iron dextran.

Use Cautiously in:

Severe hepatic impairment;
Pre-existing cardiovascular disease (disease may be exacerbated by adverse reactions to iron dextran);
Significant allergies or asthma;
History of drug allergy or multiple drug allergies (may be at ↑ risk for anaphylactic reaction);
Rheumatoid arthritis (may have exacerbation of joint swelling);
OB: Severe hypersensitivity reactions may occur which can lead to bradycardia in fetus, especially during second and third trimesters;
Lactation: Use cautiously while breastfeeding; trace amount of iron dextran appear in breast milk;
Children <4 mo (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, tachycardia

Derm: flushing, urticaria

GI: abdominal pain, nausea, taste disorder, vomiting

Local: skin staining at IM site, phlebitis at IV site, pain at IM site

MS: arthralgia, myalgia

Neuro: dizziness, headache, SEIZURES, syncope

Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), lymphadenopathy, sweating

Interactions ⬆ ⬇

Drug-drug:

Chloramphenicol and vitamin E may ↓ hematologic response to iron therapy.
ACE inhibitors may ↑ risk of anaphylactic reaction.

Availability ⬆ ⬇

Solution for injection: 50 mg/mL

Route/Dosage ⬆ ⬇

IM IV (Adults and Children ): Test dose of 0.5 mL (25 mg) is given 1 hr prior to therapy.
IM IV (Infants ): Test dose of 0.25 mL (12.5 mg) is given 1 hr prior to therapy.
IM IV (Adults and Children >15 kg): Iron deficiency: Total dose (mL) = 0.0476 ×(14.8 − actual Hgb) × lean body weight (kg) + 1 mL/per 5 kg lean body weight (up to maximum of 14 mL). Divided up and given in small daily doses until total is reached; not to exceed 100 mg/day. Total dose IV infusion: Total dose may be diluted and infused over 4–5 hr following a test dose of 10 drops (unlabeled).
IM IV (Children 5–15 kg): Iron deficiency: Total dose (mL) = 0.0476 (12 − actual Hgb) × weight (kg) + 1 mL/per 5 kg lean body weight (up to maximum of 14 mL) (not to exceed 25 mg/day in children <5 kg; 50 mg/day in children 5–10 kg; or 100 mg/day in children > 10 kg and adults).
IM IV (Adults ): Blood loss: Dose (mL) = (Blood loss [mL] × hematocrit) × 0.02.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

An essential mineral found in hemoglobin, myoglobin, and many enzymes.
Enters the bloodstream and is transported to the organs of the reticuloendothelial system (liver, spleen, bone marrow) where it is separated from the dextran molecule and becomes part of iron stores.

Therapeutic effects:

Resolution of iron deficiency anemia.

Classifications ⬆ ⬇

Therapeutic Classification: antianemics

Pharmacologic Classification: iron supplements

Pharmacokinetics ⬆ ⬇

Absorption: Approximately 5–10% of dietary iron is absorbed (up to 30% in deficiency states). Absorption with IV administration is complete. Well absorbed following IM administration.

Distribution: Remains in the body for many mo. Crosses the placenta; enters breast milk.

Protein Binding: ≥90%.

Metabolism/Excretion: Mostly recycled; small daily losses occurring via desquamation, sweat, urine, and bile.

Half-Life: 6 hours.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(effects on erythropoiesis)

ROUTE	ONSET	PEAK	DURATION
IM, IV	4 days	1–2 wk	wks–mos

Patient/Family Teaching ⬆ ⬇

Explain purpose of iron therapy to patient Advise patient to avoid iron supplementation during therapy unless instructed by health care professional.
Delayed reaction may occur 1–2 days after administration and may last 3–4 days if large, IV doses used, 3–7 days with IM route. Instruct patient to contact health care professional if fever, chills, malaise, muscle and joint aches, nausea, vomiting, dizziness, and backache occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Maternal hypersensitivity reactions (anaphylaxis, hypotension, shock) following use of parenteral iron may result in fetal bradycardia, especially during the second and third trimesters.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0023- Allergan, Inc.
- 0023-6082- INFeD
  - 0023-6082-10- 10 VIAL, SINGLE-DOSE in 1 CARTON (0023-6082-10) > 2 mL in 1 VIAL, SINGLE-DOSE

52544- Actavis Pharma, Inc.
- 52544-931- INFeD
  - 52544-931-02- 10 VIAL, SINGLE-DOSE in 1 CARTON (52544-931-02) > 2 mL in 1 VIAL, SINGLE-DOSE

52584- General Injectables and Vaccines, Inc.
- 52584-086- INFED
  - 52584-086-01- 1 VIAL, SINGLE-DOSE in 1 BAG (52584-086-01) > 2 mL in 1 VIAL, SINGLE-DOSE

52584- General Injectables and Vaccines, Inc
- 52584-931- Infed
  - 52584-931-07- 1 VIAL, SINGLE-DOSE in 1 BAG (52584-931-07) > 2 mL in 1 VIAL, SINGLE-DOSE

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Indications ⬇

Contraind./Precautions ⬆ ⬇