Side Effects of Dexferrum (iron dextran)

Dexferrum (iron dextran) is an injectable form of iron used to treat iron-deficiency anemia, a condition in which the blood doesn't have enough healthy red blood cells because of a deficiency of available iron.

Dexferrum is only used to treat patients who cannot be adequately treated with oral iron supplements. Iron is an important mineral and is a necessary component of red blood cells and their ability to carry oxygen. Iron supplements replenish iron in the body and allow the transportation of oxygen.

Common side effects of Dexferrum include

• diarrhea,
• headache,
• cramps,
• dizziness,
• upset stomach,
• changes in taste, and
• pain and irritation or swelling where the injection was given.

Other side effects of Dexferrum include

• itching,
• rash,
• skin reactions,
• nausea,
• vomiting,
• decreased white blood cell count,
• chest pain,
• high or low blood pressure,
• rapid or slow heartbeat,
• flushing,
• abnormal heart rhythms,
• joint pain,
• muscle pain,
• seizures,
• breathing problems, and
• fever.

Serious side effects of Dexferrum include

• serious anaphylactic-type reactions, including death.

Large doses of Dexferrum may cause delayed reactions such as

• joint pain,
• backache,
• chills,
• dizziness,
• moderate to high fever,
• headache,
• feeling unwell (malaise),
• muscle pain,
• nausea, and
• vomiting.

No clinically important drug-drug interactions between Dexferrum and other medications have been reported by the manufacturer.

There are no adequate and well-controlled studies of Dexferrum in pregnant women. Dexferrum should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Small amounts of Dexferrum are excreted into human milk. Dexferrum should be used cautiously in breastfeeding women.

Common side effects include:

• Loose stools (diarrhea)
• Headache
• Cramps
• Dizziness
• Upset stomach
• Change in taste
• Pain and irritation or swelling where the injection was given

Other possible side effects include:

• Itching
• Rash
• Skin
• Reactions
• Nausea
• Vomiting
• Decreased white blood cell count
• Chest pain
• Low blood pressure
• High blood pressure
• Rapid heartbeat
• Slow heartbeat
• Flushing
• Abnormal heart rhythms
• Joint pain
• Muscle pain
• Seizures
• Breathing problems
• Fever

• Severe/Fatal: Anaphylactic reactions have been reported with the use of iron dextran injection; on occasions these reactions have been fatal. Such reactions, which occur most often within the first several minutes of administration, have been generally characterized by sudden onset of respiratory difficulty and/or cardiovascular collapse. Because fatal anaphylactic reactions have been reported after administration of iron dextran injection, the drug should be given only when resuscitation techniques and treatment of anaphylactic and anaphylactoid shock are readily available.
• Cardiovascular: Chest pain, chest tightness, shock, cardiac arrest, hypotension, hypertension, tachycardia, bradycardia, flushing, arrhythmias. (Flushing and hypotension may occur from too rapid injections by the intravenous route.)
• Dermatologic: Urticaria, pruritus, purpura, rash, cyanosis.
• Gastrointestinal: Abdominal pain, nausea, vomiting, diarrhea.
• Hematologic/lymphatic: Leucocytosis, lymphadenopathy.
• Musculoskeletal/soft tissue: Arthralgia, arthritis (may represent reactivation in patients with quiescent rheumatoid arthritis), myalgia; backache; sterile abscess; brown skin and/or underlying tissue discoloration (staining); cellulitis; swelling; inflammation; local phlebitis at or near intravenous injection site.
• Neurologic: Convulsions, seizures, syncope, headache, weakness, unresponsiveness, paresthesia, febrile episodes, chills, dizziness, disorientation, numbness, unconsciousness.
• Res piratory: Respiratory arrest, dyspnea, bronchospasm, wheezing.
• Urologic: Hematuria.
• Delayed reactions: Arthralgia, backache, chills, dizziness, fever, headache, malaise, myalgia, nausea, vomiting
• Miscellaneous: Febrile episodes, sweating, shivering, chills, malaise, altered taste.

Drug/Laboratory Test Interactions

• 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 drug may cause falsely elevated values of serum bilirubin and falsely decreased values of serum calcium.
• Serum iron determinations (especially by colorimetric assays) may not be meaningful for 3 weeks following the administration of iron dextran.
• Serum ferritin peaks approximately 7 to 9 days after an intravenous dose of Dexferrum and slowly returns to baseline after about 3 weeks.
• Examination of the bone marrow for iron stores may not be meaningful for prolonged periods following iron dextran therapy because residual iron dextran may remain in the reticuloendothelial cells.
• Bone scans with 99m Tc-labeled bone seeking agents, in the presence of high serum ferritin levels or following iron dextran infusions, have been reported to show reduction of bony uptake, marked renal activity, and excessive blood pool and soft tissue accumulation.