Fatal reactions have followed the test dose of iron dextran injection. Fatal reactions have also occurred in situations where the test dose was tolerated. Circulating iron dextran is removed from the plasma by cells of the reticuloendothelial system, which split the complex into its components of iron and dextran. The iron is immediately bound to the available protein moieties to form hemosiderin or ferritin, the physiological forms of iron, or to a lesser extent to transferrin. This iron which is subject to physiological control replenishes hemoglobin and depleted iron stores. Dextran, a polyglucose, is either metabolized or excreted.
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JoJoramar To avoid staining of subcutaneous tissue, use the Z-track technique of injection. Because informatin reactions are known to occur after uneventful test doses, test doses prescrbing subsequent doses should be considered. Observe the patient for at least 1 hour after test dose administration.
The extent of risk for anaphylactoid reactions to any specific iron dextran product is unknown and may vary among products. Slow intermittent intravenous IV injection: Use of iron dextran in infants younger than 4 months of age and neonates is not recommended; there have been reports from other countries of an increased incidence of gram-negative sepsis e.
Iron stores are utilized in erythropoiesis and can be depleted during therapy even in patients with normal pre-treatment iron concentrations. There is some concern that intravenously administered iron is not used appropriately by the body. Adult men, Adolescent males, and Postmenopausal women. Safety and efficacy have not been established. Parenteral administration of iron dextran may exacerbate joint pain and swelling in patients with rheumatoid arthritis, ankylosing spondylitis, or systemic lupus erythematosus SLE.
Specific guidelines for dosage adjustments informatjon hepatic impairment peescribing not available. If test dose uneventful, give the remainder of the total dose as 25 mg of iron dextran per day IM or slow IV until the prescrubing calculated dose see equation is given. Inject deeply into the upper outer quadrant of the buttock gluteus maximus only using a 2- or 3-inch, or gauge needle. Do not administer iron dextran to patients with evidence of iron overload e. INFeD is administered by intramuscular or intravenous injection.
If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. A value of Adults, Adolescents, and Children weighing 10 kg or more. Distribution of iron dextran following intramuscular or intravenous injection involves uptake by reticuloendothelial cells of the liver, spleen, and bone marrow. Hemosiderosis secondary to long-term iron dextran treatment has primarily been reported in patients with renal failure receiving dialysis.
If necessary, iron may be given in short courses, but since iron and trientine each inhibit oral absorption of the other, 2 hours should elapse between administration of trientine and iron doses. A test dose should be given prior to administration of the initial therapeutic dose. A value of 12 may be used as a target normal hemoglobin. Iron dextran should be administered to pregnant women only if the benefits outweigh the potential risks to the fetus.
In normal, healthy adults, some daily loss of iron occurs through normal skin, hair, and nail loss, and GI losses. If supine, the patients should be in a lateral position and the injection should be into the upper-most part of the buttock. If test dose uneventful, infuse the remainder of the total calculated dose see equation IV over 2 to 6 hours.
If test dose uneventful, give the remainder of the total dose as 25 mg of elemental iron per day IM or slow IV until the total calculated dose needed given. Before administering therapeutic doses by any route, a test dose of of iron dextran should be given by the route and method of administration for which therapeutic doses are to be administered. Ankylosing spondylitis, asthma, atopy, rheumatoid arthritis, systemic lupus erythematosus SLE. Both animal and human data indicate that the bulk of intravenous iron is sequestered in the reticuloendothelial system i.
Do not add therapeutic doses of iron dextran to total parenteral nutrition TPN solutions; iron dextran may destabilize the mixture or cause the cracking of the TPN emulsion. Because anaphylactic reactions are known to occur after uneventful test doses, subsequent test doses should be considered. Transferrin delivers iron to specific receptors for deposit, where it is either incorporated into hemoglobin or oxidized and stored in combination with apoferritin as ferritin.
Consult specialized references for prescribingg of test dose to be given. Patients receiving exogenous iron therapy require periodic monitoring of hematologic and hematinic parameters i. The stability of iron dextran in TPN solutions has not been well established. Major Deferasirox chelates iron and is indicated as a treatment of iron toxicity or overdose.
Intermittent hemodialysis Before supplementing hemodialysis patients with iron dextran, a diagnosis of absolute or functional iron deficiency should be made. It would be illogical for a patient to receive both iron supplementation and deferasirox simultaneously. Monitor patients for signs and symptoms of anaphylactoid reactions during all iron dextran administrations. Concurrent use of deferiprone with iron supplements has not been studied. Uptake by these cells occurs at a rate of about 10—20 mg per hour.
Total dosage with iron dextran must be individualized according to the patients age, weight, and the degree of the iron-deficiency anemia. Total Dose Intravenous Infusion : We do not record any personal information entered above. Serious anaphylactoid reactions require appropriate resuscitative measures.
Therapy with iron should generally be delayed until 24 hours after the cessation of dimercaprol therapy. PDR Search Therefore, the therapeutic prescription use of iron is usually compatible with breast-feeding if the lactating mother needs treatment for iron deficiency. If the patient is standing, inject iron dextran into the buttock opposite the weight-bearing presvribing.
INFED PRESCRIBING INFORMATION PDF
Anemia, hemochromatosis, hemoglobinopathy, hemosiderosis. Concurrent use of deferiprone with iron supplements has not been studied. Iron dextran is contraindicated for use in patients with anemia not associated with iron deficiency. Prescribing Information Disclaimer Each 1 mL of iron dextran injection contains 50 mg of elemental iron. A stable complex is prescribimg that prevents iron from entering into further chemical reactions. Your email has been sent. According to the manufacturer, caution should be exercised if iron dextran is administered to a nursing mother.