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Overview

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This medicine contains an important and useful components, as it consists of
Disodium cromoglycate, Tetrahydrazoline HClis available in the market in concentration

Name

Iron (III)-Hydroxide Dextran Complex

Precaution

Before initiating **Iron (III)-Hydroxide Dextran Complex**, it is essential for patients to consult their healthcare provider to ensure that the treatment is appropriate. Key precautions include: - **Allergic Reactions**: The drug may cause **allergic reactions** ranging from mild rashes to severe anaphylaxis, particularly after the initial dose. It is crucial to monitor for symptoms like **swelling, difficulty breathing, or rash**. Healthcare providers should be ready to manage potential severe reactions by providing immediate medical intervention. - **Anemia Diagnosis**: **Iron supplementation** should only be used in cases of iron-deficiency anemia. It should not be used in cases of **anemia of chronic disease** or **anemia due to other causes**, as this could mask an underlying condition. - **Iron Overload**: Patients with **iron overload conditions** like **hemochromatosis** should not receive this medication, as it could exacerbate iron toxicity. - **Renal Impairment**: Caution is advised in patients with **renal disease** because of the increased risk of iron accumulation. In cases of **severe renal insufficiency**, alternative therapies should be considered. - **Pregnancy and Breastfeeding**: The use of **Iron (III)-Hydroxide Dextran Complex** during pregnancy should be done only if clearly needed. There are no sufficient studies to confirm its safety during pregnancy or breastfeeding, so the benefits and risks must be carefully weighed by the healthcare provider.

Indication

**Iron (III)-Hydroxide Dextran Complex** is primarily indicated for the treatment and prevention of **iron-deficiency anemia** in patients who: - Are unable to tolerate oral iron supplements. - Have iron malabsorption conditions or **gastrointestinal disorders** that prevent adequate oral iron absorption (e.g., **Crohn’s disease**, **celiac disease**). - Require iron supplementation due to increased demand, such as during **pregnancy** or **blood loss** (e.g., post-surgery or during chronic bleeding). The medication is particularly useful for patients who require higher doses of iron that cannot be achieved effectively with oral iron formulations. It is also used in **patients with chronic kidney disease** or those undergoing **hemodialysis** where oral iron is not sufficient.

Contra indication

**Iron (III)-Hydroxide Dextran Complex** should be avoided in patients with the following conditions: - **Iron Overload**: It is contraindicated in patients with **hemochromatosis**, **hemosiderosis**, or other **iron overload syndromes** as it may worsen the condition. - **Known Hypersensitivity to Iron Dextran**: Patients who have a history of **allergic reactions** to any iron dextran preparations should avoid this treatment due to the risk of severe allergic reactions, including **anaphylaxis**. - **Anemia Not Due to Iron Deficiency**: It is contraindicated in patients with **anemia due to causes other than iron deficiency**, such as **hemolytic anemia** or **anemia of chronic disease**, because supplementation may not be appropriate. - **Severe Renal Impairment**: **Iron (III)-Hydroxide Dextran Complex** should be avoided in patients with severe **renal failure** or **severe liver disease** due to the risk of complications related to iron metabolism and clearance.

Side Effect

Common and severe side effects of **Iron (III)-Hydroxide Dextran Complex** include: - **Allergic Reactions**: **Hypersensitivity reactions** (e.g., rash, itching, anaphylaxis) may occur, particularly after the first injection. Anaphylaxis can be life-threatening, so it is critical to observe patients closely during and after administration. - **Injection Site Reactions**: **Pain, swelling, redness**, and **irritation** at the injection site are common. In some cases, this may progress to **tissue necrosis** or **abscess formation**. - **Gastrointestinal Issues**: Although less common with intravenous formulations, **nausea**, **vomiting**, **diarrhea**, or **constipation** can occur. - **Iron Overload**: **Iron toxicity** may result from excessive iron deposition in tissues, leading to **hemochromatosis** and damage to organs such as the **heart**, **liver**, and **pancreas**. Regular monitoring of iron levels is necessary to avoid this. - **Fever and Headache**: Patients may experience **fever**, **headache**, and general **malaise** after the infusion. These symptoms are often temporary and may resolve on their own. - **Hypotension**: **Iron dextran** can cause **low blood pressure** (hypotension), especially when infused too rapidly. It is advised to monitor blood pressure throughout the infusion process.

Pregnancy Category ID

3

Mode of Action

**Iron (III)-Hydroxide Dextran Complex** works as an intravenous **iron replacement therapy** for patients with **iron deficiency**. It contains **iron in the form of a dextran complex**, which is easily broken down and absorbed by the body. - **Iron Delivery**: Once injected, the **iron dextran complex** is absorbed into the bloodstream, where it is transported to the **bone marrow** for **hemoglobin** production, contributing to red blood cell formation and improving oxygen transport. - **Prevention of Iron Deficiency**: The complex provides a controlled release of **iron**, replenishing iron stores in the body and correcting **iron-deficiency anemia**. - **Long-Term Storage**: Unlike oral iron supplements, which require regular administration, the **iron dextran complex** allows for a more sustained iron supply, reducing the need for frequent dosing.

Interaction

**Iron (III)-Hydroxide Dextran Complex** may interact with several medications and substances, affecting its efficacy or safety. Key interactions include: - **Oral Iron Supplements**: Concurrent use with oral **iron supplements** may lead to an **excessive iron load** in the body, increasing the risk of **iron toxicity**. - **Antacids and Proton Pump Inhibitors (PPIs)**: **Antacids** and **PPIs** can reduce the absorption of **iron** in the gastrointestinal tract, potentially reducing the effectiveness of **Iron (III)-Hydroxide Dextran Complex**. - **Ciprofloxacin**: **Iron** can decrease the absorption of **ciprofloxacin** and other **quinolone antibiotics**, reducing their effectiveness. These medications should be taken separately. - **Tetracyclines and Doxycycline**: **Iron** may also reduce the absorption of **tetracycline antibiotics**. It is advised to separate the administration of these medications by at least **2 hours**. - **Levodopa**: **Iron** can interfere with the absorption of **levodopa**, used in the treatment of **Parkinson's disease**, potentially reducing its therapeutic effect. - **Anticoagulants (e.g., Warfarin)**: **Iron supplementation** may enhance the anticoagulant effect of drugs like **warfarin**, increasing the risk of bleeding. Monitoring is recommended.

Pregnancy Category Note

Information not available

Adult Dose

The typical adult dose of **Iron (III)-Hydroxide Dextran Complex** is administered intravenously, with doses generally calculated based on the **patient’s body weight** and the **degree of iron deficiency**: - **Initial Dose**: The **loading dose** is typically between **500 mg to 1000 mg** of elemental iron, depending on the severity of the deficiency. The dosage may vary based on **serum ferritin levels** and **hemoglobin concentration**. - **Maintenance Dose**: A maintenance dose may be given in subsequent weeks to replenish iron stores, typically administered **every 2 to 3 weeks**. - The dosing regimen should be individualized based on **clinical response**, with **iron levels** monitored periodically.

Child Dose

The use of **Iron (III)-Hydroxide Dextran Complex** in children is typically reserved for cases where iron-deficiency anemia cannot be treated effectively with oral iron. The pediatric dose is based on **body weight** and the **degree of iron deficiency**: - **Initial Dose**: Children may receive **2 to 5 mg of elemental iron per kg** of body weight, administered via **intravenous infusion**. - **Maintenance Dose**: Maintenance doses will depend on the child’s clinical response, but **iron levels** should be monitored to avoid **iron overload**. As with adults, **careful monitoring** is required in pediatric patients to avoid the complications associated with excessive iron levels, particularly in children with underlying **chronic conditions**.

Renal Dose

For patients with **renal impairment**, particularly those undergoing **hemodialysis**, **Iron (III)-Hydroxide Dextran Complex** should be used with caution. Adjustments may be needed based on the patient's **iron levels**, but **dose reduction** is generally not required in **mild to moderate renal insufficiency**. However, in patients with **severe renal disease** or **end-stage renal failure**, careful monitoring of **iron levels** and **serum ferritin** is essential to avoid **iron overload**. Dosing adjustments should be considered by healthcare providers with expertise in **renal care**.

Administration

Information not available