Usual Adult Dose for Iron Deficiency Anemia

Administer doses of 2 mL or less, IV, once a day, until the calculated total amount required has been reached

Dose (mL) = 0.0442 (Desired hemoglobin - Observed hemoglobin) x lean body weight in kg + (0.26 x lean body weight)

Males: Lean Body Weight = 50 kg + 2.3 kg per inch in height over 60 inches
Females: Lean Body Weight = 45.5 kg + 2.3 kg per inch in height over 60 inches

• For further information refer to dosing chart in manufacturer prescribing information.

Maximum dose: 2 mL per day

Comments:

• Prior to the first therapeutic dose, administer a 0.5 mL test dose; although most reactions are evident within a few minutes, observe patients for at least 1 hour before administering the therapeutic dose.
• Discontinue oral iron prior to administration of this product.
• Use hemoglobin and hematocrit to monitor response, however iron storage may lag behind normal blood morphology.
• Infed(R) may also be administered intramuscularly.

Use: Treatment of documented iron deficiency when oral administration is unsatisfactory or impossible.

Usual Adult Dose for Anemia Associated with Chronic Renal Failure

Administer doses of 2 mL or less, IV, once a day, until the calculated total amount required has been reached

Replacement iron (in mg) = blood loss (in mL) x hematocrit

Maximum dose: 2 mL per day

Comments:

• Iron therapy should replace the equivalent amount of iron represented in the blood loss.
• Quantitative estimates of blood loss and hematocrit are needed for dose calculations.
• Prior to the first therapeutic dose, administer a 0.5 mL test dose; although most reactions are evident within a few minutes, observe patients for at least 1 hour before administering the therapeutic dose.
• Infed(R) may also be administered intramuscularly.

Use: Iron replacement for blood loss, such as periodic losses in hemorrhagic diatheses or repetitive losses such as with hemodialysis.

Usual Pediatric Dose for Iron Deficiency Anemia

Administer doses of 2 mL or less, IV, once a day, until the calculated total amount required has been reached

15 years and older (15 kg and over):
Dose (mL) = 0.0442 (Desired hemoglobin - Observed hemoglobin) x lean body weight in kg + (0.26 x lean body weight)

Males: Lean Body Weight = 50 kg + 2.3 kg per inch in height over 60 inches
Females: Lean Body Weight = 45.5 kg + 2.3 kg per inch in height over 60 inches

Children 5 to 15 kg: see dosage chart (below)
or
Dose (mL) = 0.0442 (Desired hemoglobin - Observed hemoglobin) x weight in kg + (0.26 x weight)

• Desired hemoglobin = target hemoglobin in g/dL; normal hemoglobin for children 15 kg or less is 12 g/dL
• For further information refer to dosing chart in manufacturer prescribing information.

Maximum dose:

• Infants under 5 kg: 0.5 mL per day
• Children under 10 kg: 1 mL per day
• All others: 2 mL per day

Comments:

• Prior to the first therapeutic dose, administer a 0.5 mL test dose; although most reactions are evident within a few minutes, observe patients for at least 1 hour before administering the therapeutic dose.
• Discontinue oral iron prior to administration of this product.
• Use hemoglobin and hematocrit to monitor response, however iron storage may lag behind normal blood morphology.
• InFed(R) may also be administered intramuscularly.

Use: Treatment of documented iron deficiency when oral administration is unsatisfactory or impossible.

Renal Dose Adjustments

Data not available; however, caution is recommended when administering this drug to patients with renal impairment.

• Do not use during acute phase of infectious kidney disease

Liver Dose Adjustments

Serious liver function impairment: Use with extreme care.

Precautions

US BOXED WARNING(S):
RISK FOR ANAPHYLACTIC-TYPE REACTIONS:

• Anaphylactic-type reactions, including fatalities, have followed parenteral administration of iron dextran.
• Have resuscitation equipment and personnel trained in anaphylactic treatment readily available during administration.
• Administer a test dose prior to the first therapeutic dose. If no signs/symptoms of anaphylactic type reactions occur, administer the full therapeutic dose.
• During all administrations, observe for anaphylactic-type reactions.
• Fatal reactions have occurred after the test dose, as well as in situations where the test dose was tolerated.
• Use only if clinical and laboratory investigations have established an iron deficient state not amenable to oral iron therapy.
• Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to this drug.

CONTRAINDICATIONS:

• Hypersensitivity to the product
• All anemias not associated with iron deficiency

Safety and efficacy have not been established in patients younger than 4 months.

Consult WARNINGS section for additional precautions.

Dialysis

Iron dextran is not appreciably removed by hemodialysis. Supplemental dosing following hemodialysis is not necessary.

Data not available on the use of iron dextran during peritoneal dialysis.

Comments:

• Correlation of body iron stores and serum ferritin may not be valid in chronic renal dialysis patients on this drug.

Other Comments

Administration advice:

• Prior to the first therapeutic IV dose, administer a 0.5 mL test dose at a gradual rate over at least 5 minutes; although most reactions are evident within a few minutes, observe patients for at least 1 hour before administering the therapeutic dose.
• INFeD(R): Prior to the first therapeutic intramuscular (IM) dose, administer a 0.5 mL test dose; although most reactions are evident within a few minutes, observe patients for at least 1 hour before administering the therapeutic dose.
• INFeD(R): Only inject deep IM into the muscle mass of the upper quadrant of the buttock, with a 2 or 3 inch 19 or 20 gauge needle
• INFeD(R): Use a Z-track technique for IM injections to avoid injection or leakage into the subcutaneous tissue.

Storage requirements:

• Store at room temperature.

IV compatibility:

• Do not mix with other medications or in parenteral nutrition solutions.