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INFeD
iron dextran
Black Box Warnings .
Anaphylactic-type Rxn Risk
anaphylactic-type rxns (incl. fatal) assoc. w/ parenteral iron dextran; admin. where resuscitation techniques and tx of anaphylactic-type rxns available; admin. test dose prior to first dose, continue w/ full therapeutic dose if no s/sx anaphylactic-type rxns; observe for s/sx anaphylactic-type rxns during all injections; fatal rxns have occurred following test dose and when test dose tolerated; use only if lab confirmed iron deficient state not amenable to oral iron tx; pts w/ drug allergy hx or multiple drug allergies may be at incr. risk
Adult Dosing .
Dosage forms: INJ
Special Note
- [strength clarification]
- Info: 1 mL = 50 mg elemental Fe
iron deficiency anemia
- [0.5-2 mL IM/IV qd until total dose reached]
- Start: 0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 2 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [0.0442 x (desired Hgb - observed Hgb) x LBW] + (0.26 x LBW); LBW = lean body wt in kg; refer to Lean Body Weight (Female) and Lean Body Weight (Male) calculators; use ABW in kg to calculate dose if < LBW; continue at lowest dose to maintain indices; admin. IM via z-track
iron replacement, blood loss
- [0.5-2 mL IM/IV qd until total dose reached]
- Start: 0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 2 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [blood loss (mL) x Hct (as decimal fraction)] divided by 50 (mg/mL); admin. IM via z-track
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [see below]
- serious impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ
Special Note
- [strength clarification]
- Info: 1 mL = 50 mg elemental Fe
iron deficiency anemia
- [4 mo and older, <5 kg]
- Dose: 0.2-0.5 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 0.5 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [0.0442 x (desired Hgb - observed Hgb) x wt] + (0.26 x wt); use ABW in kg to calculate dose; continue at lowest dose to maintain indices; admin. IM via z-track
- [4 mo and older, 5-10 kg]
- Dose: 0.2-1 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 1 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [0.0442 x (desired Hgb - observed Hgb) x wt] + (0.26 x wt); use ABW in kg to calculate dose; continue at lowest dose to maintain indices; admin. IM via z-track
- [4 mo and older, 10-15 kg]
- Dose: 0.2-2 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 2 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [0.0442 x (desired Hgb - observed Hgb) x wt] + (0.26 x wt); use ABW in kg to calculate dose; continue at lowest dose to maintain indices; admin. IM via z-track
- [4 mo and older, >15 kg]
- Dose: 0.2-2 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 2 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [0.0442 x (desired Hgb - observed Hgb) x LBW] + (0.26 x LBW); LBW = lean body wt in kg; refer to Lean Body Weight (Female) and Lean Body Weight (Male) calculators; use ABW in kg to calculate dose if < LBW; continue at lowest dose to maintain indices; admin. IM via z-track
iron replacement, blood loss
- [4 mo and older, <5 kg]
- Dose: 0.2-0.5 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, observe >1h; Max: 0.5 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [blood loss (mL) x Hct (as decimal fraction)] divided by 50 (mg/mL); admin. IM via z-track
- [4 mo and older, 5-10 kg]
- Dose: 0.2-1 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 1 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [blood loss (mL) x Hct (as decimal fraction)] divided by 50 (mg/mL); admin. IM via z-track
- [4 mo and older, >10 kg]
- Dose: 0.2-2 mL IM/IV qd until total dose reached; Start: 0.2-0.5 mL IM/IV test dose, allow at least 1h before admin. remainder; Max: 2 mL/dose IM or direct IV; Info: D/C other iron products before tx start; total dose (mL) = [blood loss (mL) x Hct (as decimal fraction)] divided by 50 (mg/mL); admin. IM via z-track
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: not defined
hepatic dosing
- [see below]
- serious impairment: not defined, caution advised