Monday December 26, 2005
Intravenous(IV) Iron
There are 3 forms of IV Iron available in USA. 1. Iron dextran, 2. Iron sucrose and 3. Sodium ferric gluconate. Iron dextran definitely requires "test dose" in the presence of physician with epinephrine at bedside. About 1 out of 200 patients develops life-threatening anaphylaxis. In remaining 2 forms also, test dose is advisible. Watch time after 'test dose' is about one hour. IM or SQ administration of Iron is not standard of practice.
Also dose should be calculated irrespective of form of iron use.
Iron deficiency anemia: Various formulae have been described (see references) but most widely use is
"Total" amount of iron in mg = { 0.3 x abw (lbs) x 100 (14.8 - present Hgb)] / 14.8
abw = actual body weight 14.8 is constant as ideal Hb
Calculate dose at online calculator (see Ref. 2).
In blood loss:
"Total" iron dose (in mg) = Blood loss (ml) x present Hematocrit.
The total Fe can be given as a single dose in .5 L NS over 6 hours or in divided doses over few days.
References: Click to get abstract or article
1. Administration of intravenous iron dextran - http://sickle.bwh.harvard.edu/
2. Iron Dextran Calculator - globalrph.com
3. parental iron supplement - thedrugmonitor.com
