Based on: Desired Hb = the target Hb in g/dl. Advise patients that delayed reactions can occur and that these must be reported to their healthcare provider immediately [see Warnings and Precautions (5.2)]. Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed. (See Sensitivity Testing under Dosage and Administration.) [See USP Controlled Room Temperature]. 0000012318 00000 n 0000039715 00000 n Disclaimer. What are the possible side effects of INFeD? (5.3). 1989;23(4):197-207. doi: 10.1007/BF00451642. Bookshelf [2:/T6*cz1"Jk&n#n[[TU Negligible amounts of iron are lost via the urinary or alimentary pathways after administration of iron dextran. Intravenous or intramuscular injections of INFeD are indicated for treatment of patients with documented iron deficiency in whom oral administration is unsatisfactory or impossible.. 0000011536 00000 n %PDF-1.3 Question patients regarding any prior history of reactions to parenteral iron products. Copyright 2021 GlobalRPH - Web Development by, IV Dilutions Medication Reference and Infusion Guidelines, Renal dosing for healthcare professionals, HONcode standard for trust- worthy health, 7 Natural Remedies for Rheumatoid Arthritis, How Prenatal Counseling Can Help You Through Pregnancy. Advise patients to inform their healthcare provider if any liver impairment is identified as this may cause iron toxicity. Infed (iron dextran injection USP) is an iron replacement product provided as a dark brown, slightly viscous sterile liquid complex of ferric hydroxide and dextran for intravenous or intramuscular use. 0000035990 00000 n Stability of ranitidine hydrochloride and amino acids in parenteral nutrient solutions. The following clinically significant adverse reactions are described elsewhere in the labeling: Blood and lymphatic system disorders: Leukocytosis, lymphadenopathy. 0000001877 00000 n INFeD is given undiluted at a slow gradual rate not to exceed 50 mg (1 mL) per minute. Advise patients with pre-existing cardiovascular disease and rheumatoid arthritis that Infed administration may exacerbate symptoms and to contact their healthcare provider if any symptoms occur [see Warnings and Precautions (5.3)]. Elimination <> Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to iron dextran. 0000010759 00000 n Morristown, NJ 07962 USA. Blood volume . Allergan Respiratory, thoracic and mediastinal disorders: Respiratory arrest, dyspnea, bronchospasm, wheezing. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. Obstetric clinical pharmacy: A necessary birth of a new specialty, Sister Mary Louise Degenhart dies at 85 years, Infection risk and management strategies for patients with cirrhosis taking proton pump inhibitors, Cold chain experts look to future during latest ASHP forum, National trends in prescription drug expenditures and projections for 2023, ASHP National Surveys of Pharmacy Practice in Hospital Settings, Population Health Management Theme Issues, Practice Advancement Initiative Collection, Transitions of Care/Medication Reconciliation, Emergency Preparedness and Clinician Well-being, Author Instructions for Residents Edition, Receive exclusive offers and updates from Oxford Academic, Copyright 2023 American Society of Health-System Pharmacists. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Medical Communications Fetal abnormalities in rats and dogs were observed at doses of 250 mg iron/kg and higher. If no adverse reactions are observed, Infed can be given according to the following schedule until the calculated total required dose has been reached. After administration of iron dextran complex, evidence of a therapeutic response can be seen in a few days as an increase in the reticulocyte count. 0000026302 00000 n Increased Risk of Toxicity in Patients with Underlying Conditions s sw?s4 rA,Pg_F\6IV5fbZW[Xo3tvR>el#Fd+9#Q|M-:bp6(-Ua7y3|b'O1:B`#Q)oTdQ~} B7&y"p$dKHo$zqx)|{JOj?aaZ=*#s}#;{ wQ&vYAv6bUd`l!k3X*4V. This antibiotic is active against Gram-positive aerobic and anaerobic bacteria1 2 and is commonly used in hospitals to treat serious infections.3 4 Vancomycin has slow bactericidal time-dependent activity and can be administered by continuous or . The circulating iron is bound to the available protein moieties to form hemosiderin or ferritin, or to a lesser extent to transferrin. The 5 hour value was determined for 59Fe iron dextran from a study that used laboratory methods to separate the circulating 59Fe iron dextran from the transferrin bound 59Fe. . Infed (iron dextran injection), for intravenous or intramuscular use sharing sensitive information, make sure youre on a federal In mice, rats, rabbits, and possibly hamsters, it has been demonstrated that these complexes may produce sarcoma following repeated administration of large or small doses of iron-carbohydrate complexes at a single injection site. Fetal/Neonatal Adverse Reactions Iron storage parameters may improve prior to hematologic parameters. Untreated iron deficiency anemia (IDA) in pregnancy is associated with adverse maternal outcomes such as post-partum anemia. 0000001797 00000 n Indian J Anaesth. Trace amounts of unmetabolized iron dextran are present in human milk. and transmitted securely. INFeD should be used with caution in individuals with histories of significant allergies and/or asthma. equivalent to 50 mg of elemental iron per mL. Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Do not mix with other drugs or add to parenteral nutrition solutions for IV infusion. Do not administer Infed to patients with iron overload [see Warnings and Precautions (5.4)]. The maximum daily dose of INFeD should not exceed 2 mL. 0000000016 00000 n Changes in serum ferritin levels represent the changes in calculated cellular non-heme iron levels. Attached to this memorandum is a copy of a package insert for iron dextran (Infed). endobj 0000046285 00000 n 6FT2QHi!TlT\Gv8hoo6?y^Owm-2v\o**5b[ ,kDS@TzEr.2uTBs4PT>m231qSaLHh>` PubMed PMID: 23981803. It should be understood that these half-life values do not represent clearance of iron from the body. Large doses of iron dextran (5 mL or more) have been reported to give a brown color to serum from a blood sample drawn 4 hours after administration. The stability of dilute iron dextran formulations and of one formulation in parenteral nutrient solutions was studied. 2 DOSAGE AND ADMINISTRATION Musculoskeletal and connective tissue disorders: Arthralgia, arthritis (may represent reactivation in patients with quiescent rheumatoid arthritis [see Warnings and Precautions (5.3)], myalgia, backache. Excessive therapy with parenteral iron can lead to excess storage of iron with the possibility of iatrogenic hemosiderosis. 0000005917 00000 n I. fBw2e5/6k&Dd:/7(lc\s56l<6E'0$tumU? W@mZ_$3ZwE]^ . FLeQI!/r5=J aJp0s bEl$6uwK6).d>)bdJ6z!oGUayaZ`Z5$+=6mF2xzh[*'_L'T+Rbs VJlJ-2RSJrJIRSJxJ O))%Rs9PSJ~h]@?:4O~AQ@%{Ik@Ks1y,u?%s O))%\cy c ::y[%6b;+.:.=.7WKEbWd? %PDF-1.3 % Drug class: Iron Preparations Hbd`ab`ddpwwvL)IMN5405NKIa!#6= v`b`fd4/9(3=DA!YAR1%? After slow IV injection (given over 30 seconds for INFeD or 5 minutes for Dexferrum) or IM injection (INFeD) of 25 mg of iron (0.5 mL), observe for 1 hour for sensitivity reactions (see Anaphylaxis under Cautions) before administering the remaining portion of the initial dose. Intravenous admixtures - preparation and infusion guidelines This reference contains standard dilutions including IV admixture drug concentration, infusion volumes, and infusion rates. NOTE: Do not mix INFeD with other medications or add to parenteral nutrition solutions for intravenous infusion. Dextran, a polyglucose, is either metabolized or excreted. 0000035692 00000 n Package insert / product label Possible risk of carcinogenesis associated with IM administration of iron-carbohydrate complexes. (See Anaphylaxis under Cautions.) The extent of risk for anaphylactic-type reactions following exposure to any specific iron dextran product is unknown and may vary among the products. 3. All Rights Reserved. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. PDF Storage and Reuse of Reconstituted Neuromodulators The study suggests that addition of recommended daily doses of iron dextran to parenteral nutrient solutions creates no stability problems; however, further study of the effects of temperature, pH, light, and storage time are recommended. Careers. MeSH 4. The https:// ensures that you are connecting to the Note: The table and accompanying formula are applicable for dosage determinations only in patients with iron deficiency anemia; they are not to be used for dosage determinations in patients requiring iron replacement for blood loss. 3 0 obj An official website of the United States government. J Pediatr Pharmacol Ther. Generic name: iron dextran Continue Infed until hemoglobin is within the normal range and iron stores are replete. Gastrointestinal disorders: Abdominal pain, nausea, vomiting, diarrhea. If the patient is standing, he/she should be bearing his/her weight on the leg opposite the injection site, or if in bed, he/she should be in the lateral position with injection site uppermost. Carcinogenesis Anaphylaxis and other hypersensitivity reactions have been reported after uneventful test doses as well as therapeutic doses of iron dextran injection. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. 0000002441 00000 n For information on systemic interactions resulting from concomitant use, see Interactions. The animals used in these tests were not iron deficient. Therefore, administration of subsequent test doses during therapy should be considered. Administer a test Infed dose prior to the first therapeutic dose. Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to Infed. Iron Dextran (INFeD or DexFerrum ) INFeD and DexFerrum are iron dextran pro-ducts marketed in the United States. PLEASE READ THE. Excess storage of iron and a syndrome similar to hemosiderosis possible when used for anemia not attributable to iron deficiency (e.g., those with hemoglobinopathies and other refractory anemias that might be erroneously diagnosed as iron deficiency anemias). COMMENTARY Biological parenteral products ar - American Society of Excretion Factors contributing to the formula are shown below. . Iron dextran preparations differ in chemical characteristics and may differ in clinical effects; manufacturers state that such preparations are not clinically interchangeable. . Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses. Curr Opin Clin Nutr Metab Care. The total amount of INFeD required for the treatment of iron deficiency anemia or iron replacement for blood loss is determined from the table or appropriate formula (See Dosage). N}F( 9N(i{:%NISD;%NIS*T1 1984 Mar;19(3):202, 207, 211-3. w:Z7LWT0 CIu:rz9;y| Nd'T 4'" \py?_%XySt[]O!8cf}Uhi6yf^r={qK"P-CspB_z%k6cCJbDKmE![V RRd::||7?_EeYU2&*[-%yWU0J@eZZ+)_P2B A_`T Y-site compatibility of medications with parenteral nutrition. INFeD is a prescription medicine used to treat the symptoms of Iron-deficiency Anemia. Fatal reactions have been reported following the test dose of iron dextran and have also occurred in situations where the test dose was tolerated. Parenterally administered iron does not give a faster response compared to oral administration, therefore, the rate of recovery from anemia should be the same. Last updated on Dec 1, 2022. J Pediatr Pharmacol Ther. Please check for further notifications by email. Vancomycin hydrochloride is an antibiotic belonging to the glycopeptide family and acts by inhibiting the synthesis of the peptidoglycan wall. Ling J, Gupta VD. 0000010855 00000 n LBW = Lean body weight in kg [A patients lean body weight (or actual body weight if less than lean body weight) should be utilized when determining dosage.] Parenteral iron dextran therapy: a review. Patients with rheumatoid arthritis may have an acute exacerbation of joint pain and swelling following the administration of INFeD. p?kh|*rB vg8Si*-T+/_VHEbT!AlK*3 Administer test dose prior to first therapeutic dose. Anemia Associated with Chronic Renal Failure, Hypersensitivity Reactions [see Warnings and Precautions (5.1)], Delayed Reactions [see Warnings and Precautions (5.2)], Increased Risk of Toxicity in Patients with Underlying Conditions [see Warnings and Precautions (5.3)], Iron Overload [see Warnings and Precautions (5.4)], Fetal bradycardia [see Use in Specific Populations (8.1)]. Known hypersensitivity to iron dextran or any ingredient in the formulation. After reconstitution with 19 ml water for injections, the product contains 10 mg/ml voriconazole and 160 mg/ml SBECD.
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