Iron Dextran
Iron dextran is a parenteral hematinic primarily used for the treatment and prophylaxis of **iron deficiency anemia**, most notably in neonatal food-producing animals such as piglets. Piglets are born with low iron stores and lack access to soil iron when raised indoors, making early supplementation critical to prevent anemia. In small animal medicine, iron dextran is frequently utilized as an adjunctive therapy alongside **erythropoietin (EPO)** or darbepoetin treatments in patients with chronic kidney disease, particularly when oral iron supplements are poorly tolerated or inadequately absorbed. > **Clinical Pearl:** While iron administration corrects physical signs and hemoglobin deficits secondary to iron deficiency, it does not stimulate erythropoiesis on its own, nor does it correct anemias of other etiologies.
Mechanism: Iron is an essential structural component of **hemoglobin** and **myoglobin**, facilitating oxygen transport and utilization throughout the body. It also acts as a critical cofactor for multiple metabolic enzymes. * **Pathway:** IM Injection → Slow absorption via lymphatic system → Phagocytosis by reticuloendothelial system (RES) in liver, spleen, and bone marrow → Cleavage of iron from dextran → Iron binds to **transferrin** for transport → Incorporation into **hemoglobin** in bone marrow or stored as **ferritin** and **hemosiderin**. * **Key Enzymes:** Ionized iron is a vital component of **cytochrome oxidase**, **succinic dehydrogenase**, and **xanthine oxidase**.
Dosing by species
- Prevention of transient neonatal iron deficiency anemia · 50 mg iron dextran injection at 18 days of age · IM · once
- Adjunctive therapy with erythropoietin treatment · 10 mg/kg IM every 3-4 weeks · IM · q3-4 weeks
- Adjunctive therapy with erythropoietin treatment in cats who cannot tolerate oral iron therapy · 50 mg IM q3-4 weeks · IM · q3-4 weeks
- General · 10 mg/kg IM once weekly · IM · weekly
- Iron deficiency anemia or following hemorrhage · 10 mg/kg IM; repeat in 7-10 days if PCV fails to return to normal · IM · once, repeat in 7-10 days if needed
- Iron deficiency anemia or following hemorrhage · 10 mg/kg IM; repeat weekly · IM · weekly
- Prevention of iron deficiency anemia in baby pigs (2-4 days of age) · Administer an initial intramuscular injection of 100 mg of elemental iron to each animal at 2 to 4 days of age. Dosage may be repeated in 14 to 21 days. · IM · once, repeat in 14-21 days
- Iron deficiency anemia · 10-20 mg/kg once, followed by oral therapy with ferrous sulfate · IM · once · Followed by oral therapy with ferrous sulfate
Routes of administration
Contraindications
- Known hypersensitivity to iron dextran
- Any anemia other than iron deficiency anemia
- Acute renal infections
- Concurrent use with oral iron supplements
Adverse effects
- Prostration and muscular weakness (pigs)
- Anaphylactoid reactions (rarely fatal)
- Nausea, vomiting, and sudden death within 1 hour (in pigs born to Vitamin E/Selenium deficient sows)
- Muscle tissue staining at injection site (in pigs >4 weeks old)
- Injection site sarcomas (associated with large SC doses in laboratory animals)
Drug interactions
- Chloramphenicol · May delay the response to iron administration; avoid using chloramphenicol in patients with iron deficiency anemia
Monitoring
- CBC (Complete Blood Count)
- RBC indices (MCV, MCHC)
- Adverse reactions (especially post-injection anaphylaxis)
- Serum iron (Note: values may not be meaningful for up to 3 weeks post-injection)
Overdose
Inadvertent overdose injections may lead to iron toxicity, which can cause severe gastrointestinal mucosal damage, cardiovascular collapse, and liver failure. Depending on the size of the dose, chelation therapy may be required. **Deferoxamine** is the specific chelating agent used for severe iron toxicity.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.