Iron dextran

How it works

It provides a complex of iron with dextran that is taken up by the reticuloendothelial system, releasing iron for incorporation into haemoglobin and replenishing body iron stores.

Prescribing in practice

• Serious hypersensitivity and anaphylactic reactions can occur, so it must be given where resuscitation facilities are available with monitoring during and after administration.
• Parenteral iron should not be used in the first trimester of pregnancy and is contraindicated in iron overload or non-iron-deficiency anaemia.
• Avoid extravasation, which can cause persistent skin staining at the injection site.

Monitoring

Observe the patient closely for hypersensitivity during and after each dose, and monitor haemoglobin and iron indices to guide replacement.

Counselling the patient

• Tell staff immediately if you feel unwell, dizzy, breathless or develop a rash during the infusion.
• Some delayed flu-like symptoms or joint aches can occur and usually settle.
• You will be observed for a period after the dose as a safety precaution.

Evidence & guidelines

The MHRA advises that all intravenous iron carries a risk of serious hypersensitivity and should be administered with resuscitation facilities available.