Iron Dextran

Indications

Iron Dextran is an injectable iron used to treat iron deficiency and iron deficiency anaemia (a low red blood cell count caused by lack of iron) when iron tablets cannot be used, do not work, are not tolerated, or when iron needs to be replaced quickly, for example in chronic kidney disease or heavy blood loss.

How It Works

Iron Dextran is iron bound to a sugar-like carrier (dextran). After injection, the body's cells slowly release the iron from the carrier. The iron is then stored or carried to the bone marrow, where it is used to make haemoglobin, the part of red blood cells that carries oxygen.

Dosage and Administration

Given only by a doctor or nurse in a clinic or hospital where emergency treatment is available. It is given as a slow injection or infusion into a vein, or sometimes deep into a muscle. A small test dose is usually given first, and you are watched for at least 30 to 60 minutes. The total dose is calculated by the doctor from your weight and haemoglobin level.

Interactions

Do not take iron tablets at the same time; oral iron is usually stopped before injections and restarted at least 5 days after. ACE inhibitors (such as Enalapril) may increase the risk of reactions to injected iron. Iron Dextran may affect some blood test results for a while after the dose.

Contraindications

Do not use if you have had a serious allergic reaction to Iron Dextran or other injectable iron, have anaemia not caused by iron deficiency, have iron overload (such as haemochromatosis), or have severe liver disease or an active serious infection.

Side Effects

Side effects can include headache, nausea, metallic taste, flushing, dizziness, joint or muscle aches, fever and pain or brown staining at the injection site. Delayed reactions with joint pain and fever may appear 1 to 2 days later. Serious allergic reactions (anaphylaxis) are rare but can be life-threatening, which is why it is given under supervision.

Get urgent medical help if during or after the injection you feel breathless, wheezy, faint, have chest tightness, swelling of the face, lips or throat, a widespread rash or a very fast heartbeat. Tell the nurse at once if you feel unwell during the infusion.

Pregnancy and Lactation

It should not be used in the first 3 months of pregnancy. Later in pregnancy it is used only if the doctor decides the benefit outweighs the risk, because allergic reactions could harm both mother and baby. Small amounts may pass into breast milk; ask your doctor.

Precautions and Warnings

The risk of allergic reactions is higher in people with asthma, eczema, other allergies, or immune or inflammatory conditions such as rheumatoid arthritis or lupus. Tell your doctor about any previous reaction to iron injections. Your blood count and iron levels will be checked to avoid iron overload.

Overdose

Overdose can cause iron overload over time, which may damage the liver, heart and other organs. Since it is given by health professionals, overdose is uncommon; the doctor will monitor iron levels and treat if needed.

Therapeutic Class

Parenteral iron preparation (antianaemic).

Storage

Hospital item: store as directed on the pack, usually below 25°C, protected from light. Do not freeze. Keep out of the reach of children.