iron dextran (INFeD, Imferon, Dexferrum)
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Introduction
Tradenames: Imferon, Infed, Dexferrum.
Indications
- treatment of iron deficiency when oral treatment is not feasible or ineffective
Contraindications
Dosage
- a test dose of 0.5 mL should be given prior to standard therapy (0.25 mL infants)
- diphenhydramine & epinephrine should be immediately available
- a Z-track method should be used for IM injection
- IM administration is painful & should be given in a large muscle such as the gluteus maximus
- iron-deficiency anemia
- iron replacement for blood loss
- iron (mg) = blood loss (mL) x hematocrit
- maximum daily dose:* 100 mg of iron (2 mL)
* thus replacement dose is given over several days with maxumum daily dose of 100 mg of iron (2 mL)
Injection: 50 mg iron/mL for IM or IV administration (2 mL ampule, 5 & 10 mL vial)
Pharmacokinetics
- intramuscular
- 50-90% of IM dose is rapidly absorbed
- remainder is absorbed slowly over 1 month
- intravenous
- iron uptake by reticuloendothelial system is constant
- eliminated in the urine, feces & by the reticulo- endothelial system
- elimination in urine
Adverse effects
- common (> 10%)
- staining of skin at site of IM injection, fever/chills, sweating, headache, metallic taste, nausea/vomiting, pain at injection site
- less common (1-10%)
- uncommon (< 1%)
- phlebitis, flushing, arthralgia, respiratory difficulty, lymphadenopathy
- other
- anaphylactoid reactions[5]
- cardiovascular collapse
- hypotension
- leukocytosis
- urticaria
- dizziness
- adverse reaction may be delayed 3-4 days after IM injection
- fever, lymphadenopathy, & splenomegaly may occur 4-10 days after IM injection
Mechanism of action
parenteral source of iron
More general terms
Additional terms
Component of
- ascorbate/biotin/calcium carbonate/cobalamin/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/succinate/thiamine
- ascorbate/biotin/calcium carbonate/cobalamin/dextran/folic acid/iron dextran/nicotinic acid/pantothenate/pyridoxine/riboflavin/thiamine
References
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 576
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
- ↑ 5.0 5.1 FDA MedWatch Dexferrum (iron dextran injection) - Labeling Change, 10/16/2009 http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm186899.htm