Infed Disease Interactions

There is no excretory mechanism for iron. Iron will correct only hemoglobin abnormalities due to iron deficiency and should not be used to treat conditions such as thalassemia, hemosiderosis, hemochromatosis, normocytic anemia (unless iron deficiency exists), or in patients receiving blood transfusions. Clinical monitoring of erythropoietic function and ferritin levels is recommended.

Iron is transported in plasma complexed to transferrin, a beta1-glycoprotein synthesized by the liver. Iron is cleared from the plasma by the reticuloendothelial system (including liver) and excess stored as ferritin within the reticuloendothelial system and hepatocytes. Therapy with iron dextran should be administered with extreme caution in patients with severe hepatic dysfunction.

Iron dextran has induced neurologic toxicity such as seizures, paresthesia, weakness, disorientation, and unconsciousness. Therapy with iron dextran should be administered cautiously in patients with or predisposed to neurologic dysfunction.

Cardiac toxicity such as chest pain and tightness, shock, hypertension, tachycardia and arrhythmia have occurred during iron dextran therapy. Hypotension and flushing have been reported and are thought to be infusion- rate related. Adverse reactions experienced following therapy with iron dextran may exacerbate cardiovascular complications in patients with preexisting cardiovascular disease, caution is advised.

Hypersensitivity reactions, including anaphylaxis, have occurred after uneventful test doses as well as therapeutic doses of iron dextran injection, usually within the first several minutes of administration. Iron dextran should be administered cautiously in patients with a history of significant allergies and/or asthma. Epinephrine should be immediately available in the event of acute hypersensitivity reactions.

Patients with rheumatoid arthritis may have an acute exacerbation of joint pain and swelling following the administration of iron dextran.