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.
Uses
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.
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.
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
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.
