Iron (III)-Hydroxide Dextran Complex

Iron dextran is used for the treatment of iron-deficiency anaemia where oral therapy is ineffective or impracticable. Released iron replaces the depleted iron stores in the bone marrow where it is used in the synthesis of haemoglobin. It is a parenteral iron preparation that can cause hypersensitivity reactions including serious and potentially fatal anaphylactic/anaphylactoid reactions.

• Iron deficiency anaemia (where oral therapy is ineffective or impracticable)

Adult Dose (Parenteral):

• Iron-deficiency anaemia: 25-100 mg IV or deep IM daily PRN; not to exceed 100 mg (2 mL)/day
• Total dose (mL): 0.0442 (desired Hgb - observed Hgb) x LBW + (0.26 x LBW)
• Blood loss: total iron dose in mg = blood loss (mL) x HCT
• A test dose of 0.5 mL should be given and observe patient for at least 1 hour

Child Dose (5-15 kg):

• Not to be given in first 4 months of life
• Dose = 0.0442(Desired Hgb - Observed Hgb) x BW(kg) + (0.26 × BW)

1-10%:

• Abdominal pain, Diarrhea, Nausea, Vomiting
• Arthralgia, Arthritis
• Soreness, Inflammation, Pruritus, Rash, Urticaria
• Brown discoloration of skin

Frequency Not Defined: Seizure, Chest pain, Hypotensive shock, Dyspnea, Respiratory arrest, Leukocytosis, Anaphylaxis, Hematuria

Precautions:

• Parenterally administered iron preparations can cause serious and potentially fatal anaphylactic/anaphylactoid reactions
• Hypersensitivity reactions have been reported after previously uneventful doses
• Risk is enhanced for patients with known allergies, severe asthma, eczema or other atopic allergy
• Hypotensive episodes may occur if intravenous injection is administered too rapidly
• Lactation: traces excreted in breast milk, use caution

Contraindications:

• Known serious hypersensitivity to other parenteral iron products
• Non-iron deficiency anaemia (e.g. haemolytic anaemia)
• Iron overload or disturbances in utilisation of iron (haemochromatosis, haemosiderosis)
• Decompensated liver cirrhosis and hepatitis
• Acute or chronic infection
• Acute renal failure

Drug Interactions:

• Reduced Fe absorption upon oral Fe administration earlier than 5 days after the last injection
• Reduced effect when used with chloramphenicol

Use in Pregnancy: Category C; animal studies have shown adverse effect on fetus; no adequate human studies; potential benefits may warrant use despite potential risks.

Use in Lactation: Caution in lactation; traces excreted in breast milk; use caution.

Renal Impairment: Not to be used in patients with acute renal failure; caution required.

Hepatic Impairment: Not to be used in patients with decompensated liver cirrhosis and hepatitis.

Overdose: May cause iron overload; haemochromatosis or haemosiderosis may occur; symptomatic treatment; deferoxamine chelation therapy may be considered.