Iron (III)-Hydroxide Dextran Complex

Indications

Iron (III)-Hydroxide Dextran Complex is used for: Iron deficiency anaemia

Adult Dose

Parenteral Iron-deficiency anaemia Adult: 25-100 mg IV or deep IM qDay PRN Not to exceed 100 mg (2 mL)/day Total dose (ml) = 0.0442 (desired haemoglobin - observed haemoglobin) x LBW + (0.26 x LBW) (Note: LBW = Lean body weight(kg)) 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 hr for signs for hypersensitivity. Total dose may be given in divided doses on a daily or twice wkly basis via IM inj (into the upper outer quadrant of the buttock); may also be given intravenously by total-dose infusion or as divided inj.

Child Dose

Iron-deficiency Anemia 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) Desired hemoglobin usually 12 g/dL >15 kg: 0.0442(Desired Hgb - Observed Hgb) x Lean BW(kg) + (0.26 × Lean BW)

Renal Dose

Administration

IV Preparation Standard diluent: dose/250-1000 mL NS Minimum volume: 250 mL NS IV/IM Administration IM: use z-track technique for IM administration (deep into upper outer quadrant of buttock) IV may be administered bolus at <50 mg/min or diluted in 250-1000 mL NS & infused over 1-6 hr Infuse initial 25 mL slowly, observe for allergic reactions

Contra Indications

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

Precautions

Parenterally administered iron preparations can cause hypersensitivity reactions including serious and potentially fatal anaphylactic/anaphylactoid reactions. Hypersensitivity reactions have also been reported after previously uneventful doses of parenteral iron complexes. The risk is enhanced for patients with known allergies including drug allergies, including patients with a history of 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

Pregnancy-Lactation

Pregnancy Category: C Lactation: traces excreted in breast milk, use caution

Interactions

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

Adverse Effects

Side effects of Iron (III)-Hydroxide Dextran Complex : 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

Mechanism of Action

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.