infed stability after reconstitution

0000014709 00000 n 0000006734 00000 n Medically reviewed by Drugs.com on Oct 25, 2022. Administer a test dose of Infed prior to administration of therapeutic dose [see Dosage and Administration (2.4)]. 34 0 obj <> endobj Bookshelf Advise patients that delayed reactions can occur and that these must be reported to their healthcare provider immediately [see Warnings and Precautions (5.2)]. Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to Infed. National Library of Medicine Pharmacists should emphasize the importance of adhering to the storage conditions listed on the label after the medication is reconstituted. PMC The half-life of free iron in the plasma circulation is approximately 5 hours. The maximum daily dose of INFeD should not exceed 2 mL. %PDF-1.3 0000011042 00000 n 4. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. 2. endobj 0000046285 00000 n . Administer test dose by intended route of administration for therapeutic doses prior to initial therapeutic dose. The pH of the solution is between 4.5 to 7.0. Available data from postmarketing reports with iron dextran use in pregnancy are insufficient to assess the risk of major birth defects or miscarriage. Hilleman DE, McEvoy GK, Bailey RT Jr, Reich J. Hosp Pharm. Stability of solutions of antineoplastic agents during preparation and storage for in vitro assays. No consistent adverse fetal effects were observed in mice, rats, rabbits, dogs, and monkeys at doses of 50 mg iron/kg or less. 2001;5(1):75-7. Children weighing >15 kg (33 lbs): Use the following formula (where Wt = patient's weight in kg and Hbo = observed hemoglobin in g/dL): [0.0442 Wt (14.8 g/dL Hbo)]+ (0.26 Wt) = total dosage of iron dextran injection (mL). INFeD should be injected only into the muscle mass of the upper outer quadrant of the buttock - never into the arm or other exposed areas - and should be injected deeply, with a 2-inch or 3-inch 19 or 20 gauge needle. If no adverse reactions are observed, Infed can be given according to the following schedule until the calculated total required dose has been reached. NOTE: Do not mix INFeD with other medications or add to parenteral nutrition solutions for intravenous infusion. d. Hemoglobin deficit 0000026747 00000 n Although anaphylactic reactions known to occur following INFeD administration are usually evident within a few minutes, or sooner, it is recommended that a period of an hour or longer elapse before the remainder of the initial therapeutic dose is given. W = body weight in kg . DOSAGE AND ADMINISTRATION Reports in the literature from countries outside the United States (in particular, New Zealand) have suggested that the use of intramuscular iron dextran in neonates has been associated with an increased incidence of gram-negative sepsis, primarily due to E. Coli. Ferric hydroxide or ferric oxyhydroxide in a complex with partially hydrolyzed low molecular weight dextran. This antibiotic is active against Gram-positive aerobic and anaerobic bacteria1 2 and is commonly used in hospitals to treat serious infections.3 4 Vancomycin has slow bactericidal time-dependent activity and can be administered by continuous or . The most common adverse reactions, including laboratory abnormalities, (20%) are leukopenia, lymphopenia, fatigue, anemia, neutropenia, increased creatinine, increased alanine aminotransferase,. . General disorders and administration site conditions: chest pain, chest tightness, weakness, malaise, febrile episodes, chills, shivering, sterile abscess, atrophy/fibrosis (intramuscular injection site), brown skin and/or underlying tissue discoloration (staining), soreness or pain at or near intramuscular injection sites, swelling, inflammation. The stability of injectable medications after reconstitution is presented. Distributed into milk (as traces of unmetabolized iron dextran); use with caution in nursing women. 2.2 Recommended Dosage for Iron Deficiency Anemia If there is no reaction after 1 hour continue. Anaphylactic-type reactions, including fatalities, have been reported following the parenteral administration of iron dextran injection. 2010 Mar;54(2):95-103. doi: 10.4103/0019-5049.63637. Stability of ranitidine hydrochloride and amino acids in parenteral nutrient solutions. 0000002803 00000 n .0.34% Advise pregnant persons about the risk of hypersensitivity reactions which may have serious consequences for the fetus [see Use in Specific Populations (8.1)]. Iron dextran has been shown to be teratogenic and embryocidal in mice, rats, rabbits, dogs, and monkeys when given in doses of about 3 times the maximum human dose. Unauthorized use of these marks is strictly prohibited. 88 0 obj<>stream Copyright 2021 GlobalRPH - Web Development by, IV Dilutions Medication Reference and Infusion Guidelines, Renal dosing for healthcare professionals, HONcode standard for trust- worthy health, 7 Natural Remedies for Rheumatoid Arthritis, How Prenatal Counseling Can Help You Through Pregnancy. During all Infed administrations, observe for signs or symptoms of anaphylactic-type reactions. A current package insert for the iron dextran product being used should always be reviewed, since these package inserts are periodically updated, and the product is currently made by more than one manufacturer. endstream endobj 46 0 obj<>stream The following information about each drug is given in tabular format: drug to be reconstituted and size of package; recommended route(s) of administration; recommended diluent, quantity to be used and resultant concentration; stability after initial dilution; and stability after further dilution; and stability . . 0000010118 00000 n 0000010567 00000 n The extent of risk for anaphylactic-type reactions following exposure to any specific iron dextran product is unknown and may vary among the products. . Serum iron determinations (especially by colorimetric assays) may not be meaningful for 3 weeks following the administration of Infed. endstream endobj 48 0 obj<> endobj 49 0 obj<> endobj 50 0 obj<> endobj 51 0 obj<>stream The easiest-to-prepare dilute solution (iron dextran, benzyl alcohol, and sterile water for injection) was stable for three months; stability was greater when refrigerated. Iron therapy in these patients should be directed toward replacement of the equivalent amount of iron represented in the blood loss. infed stability after reconstitutionkneecap tattoo healing. Unable to load your collection due to an error, Unable to load your delegates due to an error. In patients with CKD receiving an ESA, administer sufficient iron to maintain selected targets of iron therapy (i.e., transferrin saturation and serum ferritin concentrations); periodically monitor these iron indices and use results (in conjunction with hemoglobin concentrations and ESA dosage) to guide iron therapy. This site complies with the HONcode standard for trust- worthy health information: verify here. The following adverse reactions associated with the use of Infed were identified in clinical studies or postmarketing reports. Recommended dosage for treatment of iron deficiency anemia also may be determined from a table; consult manufacturers labeling. During administration of any iron dextran dose, observe for manifestations of anaphylactic-type reactions. Bethesda, MD 20894, Web Policies Therefore, administration of subsequent test doses during therapy should be considered. 2009;23(3):223-30. doi: 10.1080/15360280903098382. xb```f``= @Q#3108-. 1984 Mar;19(3):202, 207, 211-3. . INFeD (IRON DEXTRAN COMPLEX) INJECTION SDS EFFECTIVE DATE: SEPTEMBER 24, 2018 PAGE 1 OF 8 SAFETY DATA SHEET Prepared to U.S. OSHA, CMA, ANSI, Canadian WHMIS Standards, European Union CLP EC 1272/2008 and the Global Harmonization Standard 1. 0000036574 00000 n Y-site compatibility of medications with parenteral nutrition. endstream endobj 35 0 obj<> endobj 36 0 obj<> endobj 37 0 obj<>/Font<>/ProcSet[/PDF/Text]/ExtGState<>>> endobj 38 0 obj<> endobj 39 0 obj<> endobj 40 0 obj<> endobj 41 0 obj<> endobj 42 0 obj<> endobj 43 0 obj[/ICCBased 66 0 R] endobj 44 0 obj<> endobj 45 0 obj<>stream J Pain Palliat Care Pharmacother. All Rights Reserved. Does not stimulate erythropoiesis nor does it correct hemoglobin disturbances not caused by iron deficiency. JLdddd0]`kig?yLm[}6:|Mm-g;b%&?,X,|&Y_}:|!'l%B%e]oJ\}v8l="[;`_#3B]v4ysnp6p3oQd+j_07(+g_Co;haE+1bk+|e>inBko686Jf?2o_>qfETmP@5(C7b$;HvqW!Vb(FNz& J Pediatr Pharmacol Ther. Calculate the Infed dose based upon the formula below which is based upon the approximate amount of blood loss and pretreatment hematocrit. Infed (iron dextran injection USP) is an iron replacement product provided as a dark brown, slightly viscous sterile liquid complex of ferric hydroxide and dextran for intravenous or intramuscular use. Possible increased pathogenicity of certain microorganisms; not recommended for use during the acute phase of infectious renal disease. Following administration of Infed, circulating iron dextran is split by the cells of the reticuloendothelial system into its components of iron and dextran. Use with caution in patients with a history of clinically important allergies and/or asthma. . Iron Dextran (INFeD or DexFerrum ) INFeD and DexFerrum are iron dextran pro-ducts marketed in the United States. 0000010877 00000 n Absorption WARNING: RISK FOR ANAPHYLACTIC-TYPE REACTIONS 0000039715 00000 n Stability of solutions of antineoplastic agents during preparation and storage for in vitro assays. Careers. The total volume of Infed required for the treatment of iron deficiency anemia is determined from Table 1 or the appropriate formula listed [see Dosage and Administration (2.2)]. This reference contains standard dilutions including IV admixture drug concentration, infusion volumes, and infusion rates. In patients with chronic kidney disease (CKD) on hemodialysis, IV iron superior to orally administered iron for increasing hemoglobin concentrations and/or minimizing dosage of an erythropoiesis-stimulating agent (ESA); the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines state that the IV route is preferred for iron administration in such patients. a. The test dose should be administered in the same recommended test site and by the same technique as described in the last paragraph of this section. Alternatively the total dose may be calculated: Dose (mL) = 0.0442 (Desired Hb - Observed Hb) x LBW + (0.26 x LBW). Cancer Chemother Pharmacol. . Administer test dose prior to administration of initial and subsequent therapeutic doses of the drug and observe patient closely. Chemical and physical bases determining the instability and incompatibility of formulated injectable drugs. . 5 0 obj Development and operation of a pharmacy-based intravenous cytotoxic reconstitution service. the 6 time points after injection.15 A 94-subject rater-blinded randomized control study of EDP action potentials compared toxin used within 2 hours, 72 hours, 1, 2, 3, or 4 weeks after reconstitution; at 1 week after injection, the point of maximum effect, there was no difference in quantitative paralysis . . Such reactions may be immediate or delayed. 0000000016 00000 n Monitor response to therapy by evaluating hematologic parameters (hemoglobin and hematocrit) and iron storage parameters (serum iron, total iron binding capacity, and percent saturation of transferrin). (See Anaphylaxis under Cautions.) To avoid injection or leakage into the subcutaneous tissue, a Z-track technique (displacement of the skin laterally prior to injection) is recommended. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. endstream endobj 52 0 obj<> endobj 53 0 obj<> endobj 54 0 obj<>stream We comply with the HONcode standard for trustworthy health information. . Administer the test dose at a gradual rate over at least 30 seconds into the buttock. Although serum ferritin is usually a good guide to body iron stores, the correlation of body iron stores and serum ferritin may not be valid in patients on chronic renal dialysis who are also receiving iron dextran complex. If the patient is standing, he/she should be bearing his/her weight on the leg opposite the injection site, or if in bed, he/she should be in the lateral position with injection site uppermost. Distributed into breast milk, but only as trace amounts of unmetabolized iron dextran. Bone scans involving 99m Tc-diphosphonate have been reported to show a dense, crescentic area of activity in the buttocks, following the contour of the iliac crest, 1 to 6 days after intramuscular injections of Infed. INDICATIONS AND USAGE: Injectafer is indicated for the treatment of iron deficiency anemia in adult patients: >who have intolerance to oral iron or have had unsatisfactory response to oral iron; .12.0 g/dl, c. Iron content of hemoglobin . . There have been several reports in the literature describing tumors at the injection site in humans who had previously received intramuscular injections of iron-carbohydrate complexes. 0000011536 00000 n Possible fever and exacerbation or reactivation of joint pain and swelling with IV administration in patients with rheumatoid arthritis; use with extreme caution. Observed Hb = the patients current hemoglobin in g/dl. crobiological stability and recovery of the active drug after dilution or reconstitution should be evaluated during drug development to provide healthcare professionals with the necessary information about in-use stability. 1 0 obj 4. 2021 Allergan. S39(,``sS*|JmdcA#C-"J1GSNqH4r~INF!F!39$*Lcc$,4 (x((C!GvFL|N@2 xY@C`&6[lLf9YODqV,&$tbz*OJ%]. In mice, rats, rabbits, and possibly hamsters, it has been demonstrated that these complexes may produce sarcoma following repeated administration of large or small doses of iron-carbohydrate complexes at a single injection site. official website and that any information you provide is encrypted Blood volume . 0000005019 00000 n SEE FULL PRESCRIBING INFORMATION FOR COMPLETE BOXED WARNING. Clipboard, Search History, and several other advanced features are temporarily unavailable. . (See Iron, oral under Interactions.). Int J Pharm Compd. INFeD (iron dextran injection), for intravenous or . FOIA Infed may cause falsely elevated values of serum bilirubin and falsely decreased values of serum calcium. equivalent to 50 mg of elemental iron per mL. Do not exceed a total daily dose of 2 mL undiluted Infed. 0000010855 00000 n 0000035990 00000 n 0000010005 00000 n 0000032198 00000 n AHFS DI Essentials. 0000024030 00000 n 0000013099 00000 n RRd::||7?_EeYU2&*[-%yWU0J@eZZ+)_P2B A_`T It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. . Six different dialyzer membranes were investigated (polysulfone, cuprophane, cellulose acetate, cellulose triacetate, polymethylmethacrylate and polyacrylonitrile), including those considered high efficiency and high flux. Cardiac disorders: Cardiac arrest, tachycardia, bradycardia, arrhythmias. 0000005561 00000 n w:Z7LWT0 CIu:rz9;y| Nd'T 4'" \py?_%XySt[]O!8cf}Uhi6yf^r={qK"P-CspB_z%k6cCJbDKmE![V National Library of Medicine 0000004233 00000 n BILy@yK5] I(Y+ u YV ;bPqZ9~3oG RqK|"@k!/<9 .*JIr|R$ck4w8Szd*-qK"#AgFIyVsT`PtP_-tO=jq"~.^^2={nZU$ , The 5 hour value was determined for 59Fe iron dextran from a study that used laboratory methods to separate the circulating 59Fe iron dextran from the transferrin bound 59Fe. Recommended formula (where Wt = patient's weight in kg and Hbo = observed hemoglobin in g/dL) for calculating total dosage of iron dextran injection (in mL): Use the following formula to calculate required total dosage of iron dextran injection (in mL): Infants weighing <5 kg (11 lbs): Maximum daily dosage is 25 mg of iron. Sodium hydroxide and/or hydrochloric acid may have been used to adjust pH. Fatal reactions have been reported following the test dose of iron dextran injection. Generic name: iron dextran Use only in patients in whom a clearly established indication for parenteral iron therapy exists, confirmed by appropriate clinical and laboratory tests. 0000002644 00000 n $ Fetal and maternal toxicity has been reported in monkeys at a total intravenous dose of 90 mg iron/kg over a 14 day period. . Prior to the first intramuscular Infed therapeutic dose, administer an intramuscular test dose of 0.5 mL [see BOXED WARNING and Warnings and Precautions (5.1)]. Varicella (Var) Measles, Mumps, Rubella (MMR) Measles, Mumps, Rubella, Negligible amounts of iron are lost via the urinary or alimentary pathways after administration of iron dextran. s sw?s4 rA,Pg_F\6IV5fbZW[Xo3tvR>el#Fd+9#Q|M-:bp6(-Ua7y3|b'O1:B`#Q)oTdQ~} B7&y"p$dKHo$zqx)|{JOj?aaZ=*#s}#;{ wQ&vYAv6bUd`l!k3X*4V. If diluted, administer by IV infusion [off-label] over 16 hours. The https:// ensures that you are connecting to the The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). <> Parenteral iron administration may be associated with hypersensitivity reactions [see Warnings and Precautions (5.1)], which may have serious consequences, such as fetal bradycardia (see Clinical Considerations). stream [See USP Controlled Room Temperature]. Each monograph contains stability data, administration guidelines, and methods of preparation. 1986 Jul-Aug;40(4):142-63. 5.3 Increased Risk of Toxicity in Patients with Underlying Conditions Table 1: Total Infed Requirement for Hemoglobin Restoration and Iron Stores Replacement in Patients with Iron Deficiency Anemia* Alternatively, the total dose may be calculated using the formulas below: Adults and Children over 15 kg (33 lbs) Dose (mL) = 0.0442 (Desired Hb - Observed Hb) x LBW + (0.26 x LBW) Based on: Medical Communications The easiest-to-prepare dilute solution (iron dextran, benzyl alcohol, and sterile water for injection) was stable for three months; stability was greater when refrigerated. x&q}2(33",Y &HS4) IE][5MA0A8eT?g_>^J37_/>O?'_koJ?DE>k/~fhFh-hiQv?}{spq8[vwVZinj4i ~q;+~F[f*]WR_Lk.U}2W%hv`kO?n7gC8V.WR'GB}Y2&?|l=FLf5Q*>nm{rDY_cVk|#sZa_&_~N#vjAjqe_5x?n'j_|WlYU2RW[KK/$ 5.4 Iron Overload tran [6]. Women's Bond NFT Collection Fatal reactions have been reported following the test dose of iron dextran and have also occurred in situations where the test dose was tolerated. INFeD is indicated for treatment of adult and pediatric patients of age 4 months and older with documented iron deficiency who have intolerance to oral iron or have had an unsatisfactory response. Dosage form: injection Iron Overload Nephron. 0000004715 00000 n %PDF-1.3 % and transmitted securely. This total iron requirement reflects the amount of iron needed to restore hemoglobin concentration to normal or near normal levels plus an additional allowance to provide adequate replenishment of iron stores in most individuals with moderately or severely reduced levels of hemoglobin. . "3#$-Irc8x=B_}>_W@HqAP!I`H9+.@F.ix;i1E]"EOQ4E7M9$PB em$ Ie2} %+}hIIU}E+rS_OENx(tF_)@nRAtZn#JHg221^m+U|"vy ]yakuU Serum ferritin peaks approximately 7 to 9 days after an intravenous dose of Infed and returns to baseline after about 3 weeks. 0000002918 00000 n (See Anaphylaxis under Cautions.) Note: The table and accompanying formula are applicable for dosage determinations only in patients with iron deficiency anemia; they are not to be used for dosage determinations in patients requiring iron replacement for blood loss. The .gov means its official. Continue Infed until hemoglobin is within the normal range and iron stores are replete. p?kh|*rB vg8Si*-T+/_VHEbT!AlK*3 Disease-Associated Maternal and/or Embryo/Fetal Risk Niemiec PW Jr, Vanderveen TW, Hohenwarter MW, Gadsden RH Sr. Bullock L, Fitzgerald JF, Glick MR, Parks RB, Schnabel JG, Hancock BG. 0000036781 00000 n HR0~ A test dose of 25 mg infused over 5 minutes should be given. During all Infed administrations, observe patients for signs or symptoms of anaphylactic-type reactions. Watson Pharma, Inc. HdTr0+(R^ Available as iron dextran; dosage expressed in terms of elemental iron. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Treatment of iron deficiency when oral iron preparations are ineffective or cannot be used. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Possible exacerbation of cardiovascular complications because of adverse effects of the drug in patients with preexisting cardiovascular disease. hO4,qv(8p]4SXs?_k^ '4["G!@` \ Stability of aminophylline injection in three parenteral nutrient solutions. 1972;9:94-98. Sensitivity (e.g., anaphylactoid or anaphylactic) reactions, including fatalities, have occurred following parenteral administration of iron dextran. ~q`C34&rAd oG It is not known if INFeD is safe and effective in children younger than 4 months of age. Changes in serum ferritin levels represent the changes in calculated cellular non-heme iron levels. Known hypersensitivity to iron dextran or any ingredient in the formulation. HlTM6(R;!$+g}4h*I:-~`wIg;g5#I:X3Gs3dlg7E%~KyV0=^z@X,/%OE9oCz?=P%!XYUX8]hMW;2m%}?={ Pov5J%3LaA@a9"099^eiqk5r#ZH34`&`Eaj,@6kbBQ(BPt"`32n'OV4=:yOM2hf}"V@> Risk Summary The amount of vancomycin to treat an adult infection is superior to 1 g and so the volume administered can be higher than 100 mL. Musculoskeletal and connective tissue disorders: Arthralgia, arthritis (may represent reactivation in patients with quiescent rheumatoid arthritis [see Warnings and Precautions (5.3)], myalgia, backache. If no adverse reactions are observed, INFeD can be given according to the following schedule until the calculated total amount required has been reached. Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported following the parenteral administration of iron dextran products, including Infed. Advise patients with pre-existing cardiovascular disease and rheumatoid arthritis that Infed administration may exacerbate symptoms and to contact their healthcare provider if any symptoms occur [see Warnings and Precautions (5.3)]. 8600 Rockville Pike 1983 Jan 1;286(6358):32-6. doi: 10.1136/bmj.286.6358.32. The animals used in these tests were not iron deficient. I1US99`^cc-G:>xzV5.tD8,D\>z;qxQ)bHV\c`BWNG ni*#gU4yv{J)!VMs12EJR4>43giIU?H(MlJW52 &&RBd2i%d)jUWfk$oQs=@a+~cl Iron Deficiency Anemia: Periodic hematologic determination (hemoglobin and hematocrit) is a simple and accurate technique for monitoring hematological response, and should be used as a guide in therapy. Morristown, NJ 07962 USA. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. 5.2 Delayed Reactions Delay administration of the initial therapeutic Infed dose until 1 hour or more after the test dose. The site is secure. Bookshelf [qsXBp^z\}L88l$ 6 v~\^bdQl=;GmC;c}_6u6bMUb#&YlKS;ii.HGaToD7Wg%.[vIo6y/tIiVool#8is?8dK Iron storage parameters may improve prior to hematologic parameters. Serum ferritin may not be an accurate measure of body iron stores in patients on chronic dialysis. HHS Vulnerability Disclosure, Help 16.1 How Supplied 4. Children weighing 10 kg (22 lbs): Maximum daily dosage is 100 mg of iron. The .gov means its official. Such reactions have been generally characterized by sudden onset of respiratory difficulty and/or cardiovascular collapse. III. Infed (iron dextran injection), for intravenous or intramuscular use . Each monograph contains stability data, administration guidelines, and methods of preparation. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. 0000040000 00000 n . It should be recognized that iron storage may lag behind the appearance of normal blood morphology. 0000026302 00000 n 0000027226 00000 n Hatton RC, Portales IT, Finlay A, Ross EA. There are two preparations of IV iron available; IV iron sucrose (Venofer) given as divided dosages, and low molecular weight iron dextran (CosmoFer) this can be given as divided dose or as a total dose infusion (CosmoFer may also be given intramuscularly). INFeD should be injected only into the muscle mass of the upper outer quadrant of the buttock - never into the arm or other exposed areas - and should be injected deeply, with a 2-inch or 3-inch 19 or 20 gauge needle. Seven formulations for dilute (50 mg/dl) iron dextran solutions and four parenteral nutrient solutions containing 100 mg/liter of iron dextran were prepared. Brand names: Dexferrum, INFeD If hypersensitivity reactions occur during administration, stop Infed immediately and manage reaction medically. Iron dextran was stable in the four parenteral nutrient solutions after 18 hours of room-temperature storage. 0000009371 00000 n The following information about each drug is given in tabular format: drug to be reconstituted and size of package; recommended route(s) of administration; recommended diluent, quantity to be used and resultant concentration; stability after initial dilution; and stability after further dilution; and stability of frozen antibiotics. 2.4 Administration . . trailer Anemia Associated with Chronic Renal Failure, Hypersensitivity Reactions [see Warnings and Precautions (5.1)], Delayed Reactions [see Warnings and Precautions (5.2)], Increased Risk of Toxicity in Patients with Underlying Conditions [see Warnings and Precautions (5.3)], Iron Overload [see Warnings and Precautions (5.4)], Fetal bradycardia [see Use in Specific Populations (8.1)]. Possible risk of carcinogenesis associated with IM administration of iron-carbohydrate complexes. Do not freeze. . Following intramuscular administration, Infed is absorbed from the injection site into the capillaries and the lymphatic system. 0000006695 00000 n FLeQI!/r5=J aJp0s bEl$6uwK6).d>)bdJ6z!oGUayaZ`Z5$+=6mF2xzh[*'_L'T+Rbs VJlJ-2RSJrJIRSJxJ O))%Rs9PSJ~h]@?:4O~AQ@%{Ik@Ks1y,u?%s O))%\cy c ::y[%6b;+.:.=.7WKEbWd? Please check for further notifications by email. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. 3 0 obj 0000002294 00000 n Thank you for submitting a comment on this article. J Parenter Sci Technol. All rights reserved. Therefore, administration of subsequent test doses during therapy should be considered. It should not be used during the acute phase of infectious kidney disease. 0000002441 00000 n 2025C; excursions permitted to 1530C. Obstetric clinical pharmacy: A necessary birth of a new specialty, Sister Mary Louise Degenhart dies at 85 years, Infection risk and management strategies for patients with cirrhosis taking proton pump inhibitors, Cold chain experts look to future during latest ASHP forum, National trends in prescription drug expenditures and projections for 2023, ASHP National Surveys of Pharmacy Practice in Hospital Settings, Population Health Management Theme Issues, Practice Advancement Initiative Collection, Transitions of Care/Medication Reconciliation, Emergency Preparedness and Clinician Well-being, Author Instructions for Residents Edition, Receive exclusive offers and updates from Oxford Academic, Copyright 2023 American Society of Health-System Pharmacists. Large intravenous doses, such as used with total dose infusions (TDI), have been associated with an increased incidence of adverse reactions. Infed is not recommended for use in infants under 4 months of age [see Dosage and Administration (2.2)]. Cancer Chemother Pharmacol. After administration of iron dextran complex, evidence of a therapeutic response can be seen in a few days as an increase in the reticulocyte count. 0000003686 00000 n Copyright 2021 GlobalRPH - Web Development by, The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Patheon Italia S.p.A. Children weighing 515 kg (1133 lbs): Use the following formula (where Wt = patient's weight in kg and Hbo = observed hemoglobin in g/dL): [0.0442 Wt (12 g/dL Hbo)]+ (0.26 Wt) = total dosage of iron dextran injection (mL). This site complies with the HONcode standard for trust- worthy health information: verify here. After administration of iron dextran, evidence of a therapeutic response can be seen as an increase in the reticulocyte count. Ling J, Gupta VD. To calculate a patient's weight in kg when lbs are known: Otherwise, the total dose may be calculated using the formula below: Dose (mL) = 0.0442 (Desired Hb - Observed Hb) x W + (0.26 x W), Desired Hb = the target hemoglobin in g/dL [Normal hemoglobin for children with body weight of 15 kg (33 lbs) or less is 12 g/dL.]. bella blender cup replacement,

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