Iron-dextran

Absorption

The major portion of intramuscular injections of iron dextran is absorbed within 72 hours; most of the remaining iron is absorbed over the ensuing 3 to 4 weeks.

Toxicity

LD50 = 500 mg/kg (mouse, IV). Dosages of iron dextran in excess of the requirements for restoration of hemoglobin and replenishment of iron stores may lead to hemosiderosis. Cases of severe, sometimes fatal, allergic reactions (loss of consciousness, collapse, difficulty breathing, hives, swelling, or convulsions) and severe low blood pressure (hypotension) have been reported with the use of iron dextran.

Description

Iron dextran is a dark brown, slightly viscous liquid complex of ferric hydroxide and dextran for intravenous or intramuscular use. Iron Dextran is used for the treatment of patients with documented iron deficiency in which oral administration is unsatisfactory or impossible. It is supplied as a parenteral preparation and is used as a hematinic. (Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, p1292)
Iron-Dextran is for the parenteral treatment of iron-deficiency anemia in humans and baby pigs. Can be used as a reagent.

Chemical properties

Light to dark brown powder. Colloidal suspension of an iron-dextran complex in water. pH 5.2-6.5.

History

The therapeutic value of colloidal iron preparations was first reported in the 1950's by London and Twigg. Numerous attempts have been made to improve these iron preparations Thus dextran ([h] 0.05) is first heated with alkali, and is then neutralized in the presence of ferric chloride solution. Studies on this product have revealed that each particle consists of a central iron core, approximately 3nm diameter, surrounded by a dextran sheath of approximately 13nm diameter. The complex is visualized as a particle formed by a protective sheath of dextran attached by terminal metasaccharinic acid units to a b-FeOOH core. A solution of this complex containing 5% iron and 20% dextran (Imferon ™ ) is suitable for intramuscular and intravenous injection for treating iron deficiency anemia. The product is currently used widely for treating anemia in new-born piglets.
The use of these preparations has been re-examined in humans and a dramatic rise in hemoglobin was reported following intravenous infusion. The solution is best administered together with glucose solutions.

The Uses of Iron-dextran

Iron-Dextran (ferric hydroxide dextran complex) may be used as an intravenous iron delivery preparation. Iron-Dextran may be used to induce iron-overload to study its effects and preventative measures.

The Uses of Iron-dextran

Hematinic.

Background

Iron dextran is a dark brown, slightly viscous liquid complex of ferric hydroxide and dextran for intravenous or intramuscular use. Iron Dextran is used for the treatment of patients with documented iron deficiency in which oral administration is unsatisfactory or impossible.

Indications

For treatment of patients with documented iron deficiency in whom oral administration is unsatisfactory or impossible. Also used to replenish body iron stores in Non-Dialysis Dependent-Chronic Kidney Disease (NDD-CKD) patients receiving or not receiving erythropoietin and in Hemodialysis Dependent (HDD-CKD) and Peritoneal Dialysis Dependent (PDD-CKD) - Chronic Kidney Disease patients receiving an erythropoietin.

What are the applications of Application

Iron-Dextran is a parenteral treatment of iron-deficiency anemia in humans and baby pigs

brand name

Dexferrum (Luitpold); Infed (Wat son); Proferdex (New River).

Reactivity Profile

Iron-dextran is unstable at a pH of 5 and decomposes at 149-158° F. Iron-dextran may be sensitive to prolonged exposure to air.

Health Hazard

SYMPTOMS: The symptoms associated with exposure to Iron-dextran are headaches, vomiting, and dizziness.

Fire Hazard

Iron-dextran is combustible.

Pharmacokinetics

Iron dextran is a dark brown, slightly viscous sterile liquid complex of ferric hydroxide and dextran for intravenous or intramuscular use. It is for treatment of patients with documented iron deficiency in whom oral administration is unsatisfactory or impossible. Iron is essential to the formation of hemoglobin and to the function and formation of other heme and nonheme compounds. Untreated depletion of iron stores leads to iron-deficient erythropoiesis and, in turn, to iron deficiency anemia.

Clinical Use

Prophylaxis of iron deficiency anaemia (when oral treatment is ineffective or contraindicated)

Treatment of iron deficiency during ESA therapy especially if serum ferritin is very low (<50 nanograms/mL)

Drug interactions

Potentially hazardous interactions with other drugs
Dimercaprol: avoid concomitant use.
Oral iron: reduced absorption of oral iron

Carcinogenicity

Iron dextran complex is reasonably anticipated to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in experimental animals.

Metabolism

Dextran, a polyglucose, is either metabolized or excreted.

Metabolism

After intravenous infusion, iron dextran is taken up by the cells of the reticuloendothelial cells, particularly in the liver and spleen. The reticuloendothelial cells gradually separate iron from the iron-dextran complex. Most absorbed iron is bound to transferrin and transported to the bone marrow where it is incorporated into haemoglobin; the remainder is contained within the storage forms, ferritin or haemosiderin, or as myoglobin, with smaller amounts occurring in haem-containing enzymes or in plasma bound to transferrin.
Only very small amounts of iron are excreted as the majority released after the destruction of the haemoglobin molecule is re-used.