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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Infed
Generic Name
Iron Dextran
Active Ingredient
Iron DextranCategory
Vitamin B12 [EPC]
Variants
2
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Infed, you must consult a qualified healthcare professional.
Detailed information about Infed
Iron Dextran is a complex of ferric hydroxide and dextran used to treat iron deficiency anemia in patients for whom oral iron is ineffective or impractical. It belongs to the iron replacement product pharmacological class.
The dosage of Iron Dextran is highly individualized and must be calculated based on the patient's weight and current hemoglobin level. Healthcare providers typically use the Ganzoni formula or a standardized calculation to determine the total iron deficit.
Iron Dextran may be used in pediatric patients with iron deficiency anemia. It is generally not recommended for infants under 4 months of age.
As with adults, the total dose must be calculated based on the child's weight and hemoglobin deficit.
No specific dose adjustments are required for patients with renal impairment. However, iron status should be monitored closely in patients with chronic kidney disease (CKD), as they often require concurrent erythropoiesis-stimulating agents (ESAs).
Caution is advised in patients with severe liver disease. Since the liver is a primary site for iron storage and processing, iron overload must be avoided. Iron Dextran should be avoided in patients with clinical evidence of iron overload (hemochromatosis).
Clinical studies have not identified significant differences in response between elderly and younger patients. However, dose selection should be cautious, starting at the lower end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function.
Iron Dextran must be administered by a healthcare professional in a facility equipped to handle emergency allergic reactions.
Since Iron Dextran is administered in a clinical setting by healthcare providers, missed doses are rare. If you miss a scheduled appointment for an injection, contact your clinic immediately to reschedule. Consistent adherence to the treatment plan is necessary to correct anemia.
Acute overdose of Iron Dextran is unlikely due to clinical administration, but chronic over-administration can lead to hemosiderosis (excessive iron accumulation in tissues). Symptoms of acute iron toxicity include abdominal pain, vomiting, and cardiovascular collapse. In cases of chronic overload, iron chelation therapy (such as deferoxamine) may be required to remove excess iron from the body.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or frequency of administration without medical guidance.
Common side effects associated with Iron Dextran administration include:
Iron Dextran is a potent medication that requires strict medical supervision. It is not a first-line treatment for iron deficiency and should only be used when oral iron is not an option. Patients with a history of multiple drug allergies or asthma may be at a higher risk for hypersensitivity reactions. It is essential to inform your doctor of your full medical history, especially any history of immune system disorders or chronic infections.
Anaphylactic-type reactions, including fatalities, have followed the parenteral administration of iron dextran injection. Such reactions have been reported following the first dose, the test dose, or even after multiple uneventful doses. Healthcare providers must ensure that epinephrine and other emergency resuscitative equipment are available during administration. Every patient must receive a 25 mg test dose before the full therapeutic dose is given.
Iron Dextran must NEVER be used in the following conditions:
Conditions requiring careful risk-benefit analysis include:
Iron Dextran is classified as FDA Pregnancy Category C. This means that animal reproduction studies have shown an adverse effect on the fetus, and there are no adequate and well-controlled studies in humans. However, the potential benefits may warrant use of the drug in pregnant women despite potential risks, especially if severe anemia poses a threat to the mother or the pregnancy. Iron deficiency anemia during pregnancy is associated with increased risks of preterm birth and low birth weight. Use during the first trimester is generally avoided unless absolutely necessary. If used, it should be administered with extreme caution due to the risk of maternal anaphylaxis, which can cause fetal distress.
Trace amounts of iron dextran are excreted in breast milk. While the amount of iron the infant receives via milk is likely negligible and not expected to cause harm, the long-term effects are not well-documented. Healthcare providers usually consider the benefits of treating the mother's anemia against the potential risks to the nursing infant. Monitoring the infant for gastrointestinal changes (like constipation) is a reasonable precaution.
Iron Dextran is approved for use in pediatric patients for the treatment of iron deficiency anemia. However, it is generally not recommended for infants under 4 months of age due to lack of safety data in this specific age group. Dosing in children must be meticulously calculated based on weight and hemoglobin levels to avoid accidental iron poisoning. Growth and development should be monitored as part of the overall management of anemia.
Iron Dextran is a complex of ferric hydroxide with dextran. Following administration, the complex is taken up by the cells of the reticuloendothelial system (RES), particularly macrophages. Within these cells, the iron is dissociated from the dextran shell. The released ferric iron ($Fe^{3+}$) then binds to endogenous transferrin, the primary iron transport protein in human plasma. This iron-transferrin complex is then delivered to the erythroid precursor cells in the bone marrow, where it is internalized and the iron is incorporated into the protoporphyrin ring to form heme, and subsequently, hemoglobin.
The primary pharmacodynamic effect of Iron Dextran is the increase in hemoglobin production and the replenishment of depleted iron stores. The onset of action is not immediate; while serum iron levels rise quickly, an increase in the reticulocyte count (new red blood cells) is typically seen within 3 to 7 days. A significant rise in hemoglobin levels usually takes 2 to 4 weeks of therapy. The duration of effect depends on the total dose administered and the patient's ongoing iron loss.
| Parameter | Value |
Common questions about Infed
Iron Dextran is primarily used to treat iron deficiency anemia in patients who cannot take oral iron supplements or for whom oral iron has proven ineffective. This includes individuals with severe gastrointestinal side effects from tablets, those with malabsorption disorders like Celiac disease, or patients with chronic blood loss. By providing iron directly via injection, it bypasses the digestive system to quickly replenish iron stores. It is an essential treatment for restoring hemoglobin levels and improving symptoms like extreme fatigue and shortness of breath. Your doctor will confirm the diagnosis of iron deficiency through blood tests before prescribing this medication.
The most common side effects of Iron Dextran include nausea, vomiting, and abdominal pain shortly after the injection. Patients receiving the medication intramuscularly often experience pain, swelling, and a brown staining of the skin at the injection site. Some people also report flushing, dizziness, or a temporary drop in blood pressure during the infusion. A 'delayed reaction' consisting of joint and muscle pain may also occur one to three days after treatment. While these are common, any symptom should be reported to your healthcare provider for evaluation.
There is no direct chemical interaction between alcohol and Iron Dextran; however, caution is generally advised. Chronic or heavy alcohol consumption can lead to liver damage, and since the liver is the primary organ that stores and processes iron, this can complicate your treatment. Furthermore, alcohol can sometimes interfere with the production of red blood cells, potentially slowing your recovery from anemia. It is best to discuss your alcohol intake with your doctor to ensure it does not interfere with your specific health needs. Always follow your healthcare provider's advice regarding lifestyle choices during treatment.
Iron Dextran is classified as a Category C medication by the FDA, meaning its safety during pregnancy has not been fully established through controlled human trials. While it can be used to treat severe iron deficiency anemia that poses a risk to the mother and fetus, it is generally avoided during the first trimester. The primary concern is the risk of a severe allergic reaction (anaphylaxis) in the mother, which could deprive the baby of oxygen. Your healthcare provider will carefully weigh the benefits of treating your anemia against these potential risks. If you are pregnant or planning to become pregnant, notify your doctor immediately.
While Iron Dextran increases the amount of iron in your blood immediately after injection, it takes time for your body to produce new red blood cells. You may begin to see an increase in 'reticulocytes' (young red blood cells) within 3 to 7 days. However, a noticeable improvement in your hemoglobin levels and energy levels usually takes between 2 to 4 weeks. Most patients require a series of injections or a calculated total dose to fully replenish their iron stores. Your doctor will perform follow-up blood tests to monitor your progress and determine if further doses are needed.
Iron Dextran is typically administered as a specific course of injections to reach a calculated iron target, rather than as a daily long-term medication. Therefore, there is no risk of 'withdrawal' if you stop the treatment. However, if you do not complete the full course recommended by your doctor, your iron stores may remain low, and your anemia may not fully resolve. If you are experiencing side effects that make you want to stop treatment, you must discuss this with your healthcare provider. They can determine if a different iron formulation would be more suitable for you.
Because Iron Dextran is administered by a healthcare professional in a clinic or hospital setting, missing a dose usually means missing an appointment. If this happens, contact your doctor's office as soon as possible to reschedule. It is important to stay on schedule to ensure your iron levels are restored efficiently. Missing doses can delay your recovery from anemia and prolong symptoms like fatigue. Do not attempt to 'double up' on doses or take oral iron to compensate for a missed injection without consulting your medical team.
Weight gain is not a recognized or common side effect of Iron Dextran. The medication works to restore iron levels and does not contain calories or affect the metabolic processes typically associated with weight changes. However, as your anemia improves and your energy levels return, you may find that your appetite increases or your activity levels change, which could indirectly influence your weight. If you notice sudden or unusual weight gain while receiving treatment, you should discuss it with your doctor to rule out other causes, such as fluid retention or unrelated medical conditions.
Iron Dextran can interact with several other medications, so it is vital to provide your doctor with a full list of everything you take. It should not be taken at the same time as oral iron supplements, as it can stop them from being absorbed. There is also a known risk when taking Iron Dextran alongside ACE inhibitors (common blood pressure medications), which may increase the chance of an allergic reaction. Other drugs, like the antibiotic chloramphenicol, may make the iron treatment less effective. Your doctor will review your medications to ensure there are no dangerous combinations.
Yes, Iron Dextran is available as a generic injection. The brand name INFeD is the most well-known version currently available in the United States. Generic versions must meet the same FDA standards for safety, strength, and quality as the brand-name product. Because Iron Dextran is a complex biological-like molecule, it is important that the specific formulation used is consistent. Your healthcare provider or hospital pharmacy will typically determine which version is administered based on availability and institutional guidelines. Both generic and brand-name versions require the same mandatory test dose and monitoring.
Other drugs with the same active ingredient (Iron Dextran)
> Warning: Stop receiving Iron Dextran and call your doctor immediately if you experience any of these symptoms during or after the injection:
The primary concern with long-term or repeated Iron Dextran use is Iron Overload (Hemosiderosis). Excessive iron can deposit in the liver, heart, and pancreas, leading to organ damage, cirrhosis, or heart failure. Regular monitoring of serum ferritin and transferrin saturation is mandatory for patients receiving long-term therapy to ensure iron levels remain within a safe therapeutic range. Additionally, permanent skin staining can occur if the Z-track technique is not properly utilized during intramuscular injections.
Iron Dextran carries a prominent FDA Black Box Warning regarding the risk of anaphylactic-type reactions. Fatal reactions have occurred following the administration of iron dextran injection. These reactions can occur even in patients who have previously tolerated the medication or who have had a negative test dose. Because of this risk, Iron Dextran should only be administered when resuscitation equipment and trained personnel are immediately available. A test dose of 25 mg must be administered prior to the first therapeutic dose, and the patient must be monitored closely for at least one hour.
Report any unusual symptoms to your healthcare provider immediately. Side effects can be reported to the FDA at 1-800-FDA-1088.
Patients receiving Iron Dextran require regular laboratory monitoring to ensure safety and efficacy:
Iron Dextran may cause dizziness or lightheadedness, particularly immediately following an injection or infusion. Patients should wait to see how they feel after the procedure before attempting to drive or operate heavy machinery. It is often recommended to have someone else drive you home after your first few treatments.
There are no known direct interactions between alcohol and Iron Dextran. However, chronic alcohol use can damage the liver and interfere with the body's ability to process iron. Discuss your alcohol consumption with your doctor, especially if you have underlying liver concerns.
Iron Dextran therapy is typically discontinued once the calculated iron deficit has been replaced and iron stores (ferritin) have reached a target level. There is no 'withdrawal syndrome' associated with stopping Iron Dextran, as it is not a daily maintenance medication. However, if the underlying cause of iron loss (e.g., internal bleeding) is not addressed, anemia may recur.
> Important: Discuss all your medical conditions with your healthcare provider before starting Iron Dextran.
Because Iron Dextran is administered by injection, food does not affect its absorption. There are no specific dietary restrictions required while receiving this medication. However, maintaining a balanced diet rich in vitamins (like Vitamin C, which aids natural iron handling) is generally encouraged for patients with anemia.
Iron Dextran can interfere with several laboratory tests for up to 1-2 weeks after administration:
For each major interaction, the management strategy usually involves either temporary discontinuation of the interacting agent or increased clinical monitoring during the period of iron administration.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Patients who are allergic to other dextran-containing products (such as Dextran 40 or Dextran 70 used as plasma expanders) may have a cross-sensitivity to Iron Dextran. It is vital to disclose any past reactions to IV fluids or other iron products (like Iron Sucrose or Ferric Carboxymaltose) to your healthcare provider, although the dextran component is unique to this specific formulation.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Iron Dextran.
Elderly patients may be at a higher risk for adverse cardiovascular effects, such as hypotension, during Iron Dextran infusion. Because older adults are more likely to have multiple comorbidities (like heart or kidney disease) and take multiple medications (polypharmacy), the risk of drug interactions (e.g., with ACE inhibitors) is higher. Renal clearance of the dextran component may also be slower in the elderly. Healthcare providers typically start with smaller, more frequent doses rather than a single large infusion.
In patients with chronic kidney disease (CKD), Iron Dextran is often used to manage anemia, particularly for those on hemodialysis. While the iron itself is not cleared by the kidneys, the dextran polysaccharide component is. No specific dose adjustment is required based on GFR, but iron status must be monitored very closely to prevent overload, as these patients often receive multiple blood transfusions and other iron-stimulating therapies.
Iron Dextran should be used with significant caution in patients with hepatic impairment (Child-Pugh Class B or C). The liver is the primary storage organ for iron (as ferritin). In patients with liver damage, the risk of iron-induced hepatotoxicity is increased. Regular monitoring of liver enzymes and iron markers is essential.
> Important: Special populations require individualized medical assessment and close clinical monitoring.
| Bioavailability | 100% (IV); ~60-90% (IM) |
| Protein Binding | Very high (as transferrin-bound iron) |
| Half-life | 5-20 hours (dose-dependent) |
| Tmax | Immediate (IV); 24-72 hours (IM) |
| Metabolism | RES macrophage dissociation |
| Excretion | Minimal (Renal <1%, Fecal <1%) |
Iron Dextran is a dark brown, slightly viscous liquid. Its molecular formula is approximately $[FeO(OH)]_n[C_6H_{10}O_5]_m$. It has a high molecular weight of approximately 165,000 Daltons. The complex is highly soluble in water and stable at a physiological pH of 5.2 to 6.5. The dextran component is a polymer of glucose. Unlike simple iron salts, the dextran complex prevents the rapid release of free iron into the plasma, which would otherwise be toxic.
Iron Dextran is classified as an Iron Replacement Product or Parenteral Hematinic. It is part of a group of medications that includes Iron Sucrose (Venofer), Ferric Gluconate (Ferrlecit), and Ferric Carboxymaltose (Injectafer). Among these, Iron Dextran is unique due to its high molecular weight and the mandatory requirement for a test dose due to the dextran-associated anaphylaxis risk.