Drug Index

Iron Products

Synonyms :

Carbonyl Iron, Ferric Carboxymaltose, Ferric Citrate, Ferric Hydroxide Polymaltose Complex, Ferrous Ammonium Citrate, Ferrous Ascorbate, Ferrous Dextran, Ferrous Fumarate, Ferrous Gluconate, Ferrous Sulphate, Iron Dextran Complex

Mechanism :

The iron in circulation is immediately bound to the available protein moieties to form hemosiderin or ferritin, the physiological forms of iron, or to a lesser extent to transferrin. This iron which is subject to physiological control replenishes hemoglobin and depleted iron stores.

Indication :

  • Iron deficiency anemia
  • Prophylaxis of iron deficiency in low birth weight and breast-fed babies

Contraindications :

Contraindicated in known hypersensitivity, hemochromatosis, hemosiderosis, anemia not caused by iron deficiency. Parenteral iron is contraindicated in untreated pyelonephritis and in acute liver disease.

Dosing :

All mg doses are expressed as elemental iron.
Prophylaxis of iron deficiency in low birth weight and breast-fed babies:
<1 month: 5-6 mg PO once daily.
Infants and children <12 years: 1-2 mg/kg/day (Maximum 15 mg) in 1 to 2 divided doses.
Iron deficiency anemia:
Oral: Premature neonates: 2-4 mg/kg/day PO in divided doses, Max daily dose: 15 mg.
3 months-12 years: Mild to moderate iron deficiency anemia: 3 mg/kg PO in 2 divided doses. Severe iron deficiency anemia: 4-6 mg/kg PO in 2-3 divided doses
12-18 years: 180 mg PO in 3 divided doses.
IV/IM injection: Various formulations available are:
Iron dextran: 50 mg/mL. Iron sucrose: 20 mg/mL, Ferric gluconate: 12.5 mg/mL. IV injection should not to be given in first 4 months of life. Sodium chloride 0.9% should be used as the diluent in total dose infusion. The various formulas can be used to determine the dose:
Iron dose (Mg) = (target Hb - actual Hb in g/L) x bodyweight(kg) x 0.24 + Iron depot
Note: 500 mg iron for iron stores is recommended if the body weight is above 35 kg.
Volume of product required (ML) = [weight (kg) x (14 - Hgb) x (2.145)]/C
Where C = concentration of elemental iron (Mg/ml) in the product being used:
Formula for Iron dextran: Dose (ML) = 0.0442 (Desired Hb - Observed Hb) x LBW + (0.26 x LBW)

Adverse Effect :

Nausea, epigastric pain, diarrhea, constipation, black stools, taste disturbances, dizziness, flushing, stained teeth, headache. With IV iron: pain or discoloration at injection site, hypersensitivity side effects (dyspnea, urticaria, rashes, itching, arthralgia, myalgia, fever, and sweating, anaphylaxis), arthralgia, backache, myalgia, fever, chills, dizziness, headache, nausea and/or vomiting, chest pain or tightness, shock, hypotension, hypertension, tachycardia, flushing, and arrhythmias, leucocytosis, lymphadenopathy, latent folic acid deficiency, pleocytosis, pancytopenia, thrombocytopenia, and purpura.

Interaction :

Antacids, Milk, Tetracycline, Zinc: Absorption of oral iron is decreased.
Ciprofloxacin, Levofloxacin, Norfloxacin, Ofloxacin, Tetra­cycline, Levodopa, Penicillamine: Absorption is decreased by oral iron.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
02/21/2024 01:07:05 Iron Products
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