Iron dextran Side Effects

Not all side effects for iron dextran may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to iron dextran: parenteral injection

Side effects include:

Sensitivity (e.g., anaphylactoid or anaphylactic) reactions; can be immediate or delayed and vary widely in severity.

For Healthcare Professionals

Applies to iron dextran: injectable solution


Hypersensitivity side effects have included dyspnea, urticaria, rashes, itching, arthralgia, myalgia, fever, and sweating. Hypersensitivity reactions to iron dextran are reported to occur in 2.47% of patients. Anaphylaxis, usually occurring within minutes and characterized by sudden onset of cardiorespiratory collapse, has occurred rarely (< 1% of patients).

There have been reports of fatal anaphylaxis. Anaphylaxis may occur following iron administration by the intravenous or intramuscular route. Epinephrine, intravenous diphenhydramine, methylprednisolone and oxygen should be available for immediate use when administering iron dextran.


General side effects have rarely included severe adverse reactions (less than 5%).

Delayed reactions may occur 1 to 2 days after administration of iron dextran, manifested by arthralgia, backache, myalgia, fever, chills, dizziness, headache, nausea and/or vomiting. The etiology of these reactions is unknown.

Delayed reactions tended to subside within 2 to 7 days. This type of reaction may be more common after total dose infusion, although still may occur after intramuscular injection. The severity or frequency of delayed reactions may be reduced by lowering the dose or increasing the dosing interval.


Cardiovascular side effects have included chest pain or tightness, shock, hypotension, hypertension, tachycardia, flushing, and arrhythmias. Rapid administration of iron dextran intravenously may precipitate flushing and hypotension.


Gastrointestinal side effects have included abdominal pain, nausea, vomiting, and diarrhea.


Hematologic side effects have included leukocytosis, lymphadenopathy, latent folic acid deficiency, pleocytosis, pancytopenia, thrombocytopenia, and purpura. Hemosiderosis resulting from excess storage of iron has been reported as a possible result of unwarranted therapy with parenteral iron.


Musculoskeletal side effects have included arthralgia, arthritis (possible reactivation of quiescent rheumatoid arthritis), myalgia, and backache. Rhabdomyolysis has been reported in one case report.


Local side effects have included injection site pain, inflammation and swelling, cellulitis, phlebitis, sterile abscess, brown skin staining at injection site (harmless), sarcoma formation, and necrosis. These effects have especially been observed with intramuscular injections of iron dextran.

When dextrose 5% is used as a diluent in total dose infusion of iron dextran, a higher incidence of phlebitis and local injection pain has been seen. Sodium chloride 0.9% should be used as the diluent in total dose infusion.

Nervous system

Nervous system side effects have included headache, transient paresthesia, weakness, dizziness, syncope, disorientation, unresponsiveness and seizures.


Respiratory side effects have included dyspnea, bronchospasm and respiratory arrest.


Immunologic side effects have included a possible increase in susceptibility to infections.

Increased susceptibility to infections has been observed in malnourished patients receiving iron dextran. Blood transfusions may be an option to consider in patients who are severely protein malnourished.

Studies have indicated a possible increase in susceptibility to infections in hemodialysis patients receiving iron dextran intravenously.


Renal side effects have included hematuria or anuria.


Oncologic side effects have included reports of sarcoma.


Ocular side effects have rarely included pigment epitheliopathy with serious detachment of the retina (one case report).


Hepatic side effects have included hemosiderosis, the accumulation of unusable iron in the liver and spleen. This has been associated with chronic intravenous use of this drug in patients undergoing hemodialysis. These patients may not have had adequate iron required for erythropoiesis.


Other sided effects have included altered taste, meningism and a red- brown color pigmentation to the plasma.

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