Dosing and uses of INFeD (iron dextran complex)
Adult dosage forms and strengths
injectable solution
- 50mg (Fe)/mL
Iron-deficiency Anemia
25-100 mg IV or deep IM qDay PRn
Not to exceed 100 mg (2 mL)/day
Iron deficiency: Dose = 0.0442(Desired Hgb - Observed Hgb) x Lean BW(kg) + (0.26 × Lean BW)
Blood loss: total iron dose in mg = blood loss (mL) x HCt
Pediatric dosage forms and strengths
injectable solution
- 50mg (Fe)/mL
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)
INFeD (iron dextran complex) adverse (side) effects
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
Warnings
Black box warnings
Anaphylactic type reactions, sometimes fatal, have occurred with parenteral use of this product. Reserve for use only in patients with laboratory-confirmed iron deficiency who are unable to take oral iron.
Contraindications
Hypersensitivity
Anemia not associated with iron deficiency
Acute phase of infectious renal disease
Cautions
Use caution in rheumatoid arthritis, HIV+ patients, history of allergies, history of asthma, severe hepatic impairment, preexisting cardiovascular disease
May increase pathogenicity of certain microorganisms
May induce hemosiderosis if used for non-iron-deficiency anemia
Pregnancy and lactation
Pregnancy category: C
Lactation: traces excreted in breast milk, use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of INFeD (iron dextran complex)
Mechanism of action
Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin
Pharmacokinetics
Half-Life: 6 hr
Onset: 7-9 days (serum ferritin peak)
Peak Plasma Time: 10 days
Absorption: Within 72 hr (IM)
Excretion: Minimal through urine and feces
Dialyzable: No
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
Have epinephrine nearby
Storage
Store at room temp
