Iron Dextran
Ferric oxyhydroxide and dextran complex
Also known as: Cosmofer · DexFerrum · Dexiron · Driken · Fercayl · Ferrocel · Ferroin · Ferrum Hausmann · Fexiron · Imferdex · Imferon · InFeD · Infufer · Ferrextran-100 · iron-dextran complex
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Iron deficiency anemia | 10-20 mg/kg once, followed by oral therapy with ferrous sulfate | IM | once | — | 🌎 NA |
- Iron deficiency anemia: Followed by oral therapy with ferrous sulfate
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Prevention of transient neonatal iron deficiency anemia | 50 mg iron dextran injection at 18 days of age | IM | once | — | 🌎 NA |
| Adjunctive therapy with erythropoietin treatment | 10 mg/kg IM every 3-4 weeks | IM | q3-4 weeks | — | 🌎 NA |
| Adjunctive therapy with erythropoietin treatment in cats who cannot tolerate oral iron therapy | 50 mg IM q3-4 weeks | IM | q3-4 weeks | — | 🌎 NA |
Ferrets
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| General | 10 mg/kg IM once weekly | IM | weekly | — | 🌎 NA |
Birds
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| 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 | — | 🌎 NA |
| Iron deficiency anemia or following hemorrhage | 10 mg/kg IM; repeat weekly | IM | weekly | — | 🌎 NA |
Swine
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| 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 | — | 🌎 NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
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 of action
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.
Safety & warnings
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)
Precautions
Pregnancy: High dosages may cause increased incidences of teratogenicity and embryotoxicity (FDA Category C). Use only when clearly necessary at recommended doses. Nutritional Deficiencies: Extreme caution in pigs born to Vitamin E/Selenium deficient sows due to risk of sudden death. Laboratory Interference: Large doses may discolor serum brown, causing falsely elevated serum bilirubin and falsely decreased serum calcium values. Serum iron values may not be meaningful for up to 3 weeks post-injection. Incompatibilities: Physically incompatible when mixed with oxytetracycline HCl and sulfadiazine sodium.
Drug interactions
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)
Pharmacokinetics
Absorption
Slowly absorbed primarily via the lymphatic system after IM injection. About 60% is absorbed within 3 days; up to 90% is absorbed after 1-3 weeks. The remainder may be absorbed slowly over several months.
Distribution
Iron crosses the placenta (form unknown). Only traces are excreted in milk. Iron is immediately bound to protein elements to form hemosiderin, ferritin, or transferrin.
Metabolism
Reticuloendothelial cells of the liver, spleen, and bone marrow gradually clear the drug from plasma. Iron is cleaved from the dextran component; dextran is then metabolized or excreted.
Elimination
Not readily eliminated from the body. Liberated iron is reused. Only trace amounts are lost via hair/nail growth, skin desquamation, GI tract sloughing, feces, bile, or urine. Accumulation can result with repeated dosing.
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.
Available products
Formulations
- Injectable solution
Veterinary
- Iron Dextran Injection: 100 mg of elemental iron/mL in 100 mL vials
- Iron Dextran Injection: 200 mg of elemental iron/mL in 100 mL vials
Human-labeled
- Iron Dextran Injection: 50 mg of elemental iron/mL (as dextran) in 1 mL & 2 mL single-dose vials
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at room temperature (15-30°C); avoid freezing. Physically incompatible when mixed with oxytetracycline HCl and sulfadiazine sodium.
Client information
- Purpose: This injection provides essential iron to help your animal build healthy red blood cells and treat or prevent anemia.
- Administration: The medication is given as an injection into the muscle.
- For Pig Owners: Inject IM in the back of the ham. Be aware that injecting pigs older than 4 weeks may cause permanent staining of the muscle tissue.
- Side Effects: Mild soreness at the injection site may occur. Watch for signs of weakness or severe allergic reactions shortly after the injection and contact your veterinarian immediately if they occur.
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.