iron dextran complex (Rx)

Brand and Other Names:INFeD, Dexferrum
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 50mg (Fe)/mL

Iron-deficiency Anemia

25-100 mg IV or deep IM qDay PRN

Not to exceed 100 mg (2 mL)/day

Iron deficiency: Dose = 0.0442(Desired Hgb - Observed Hgb) x Lean BW(kg) + (0.26 × Lean BW)

Blood loss: total iron dose in mg = blood loss (mL) x HCT

Dosage Forms & Strengths

injectable solution

  • 50mg (Fe)/mL

Iron-deficiency Anemia

>15 kg: 0.0442(Desired Hgb - Observed Hgb) x Lean BW(kg) + (0.26 × Lean BW)

5-15 kg

  • Not to be given in first 4 months of life
  • Dose = 0.0442(Desired Hgb - Observed Hgb) x BW(kg) + (0.26 × BW)
  • Desired hemoglobin usually 12 g/dL
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Interactions

Interaction Checker

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            Contraindicated (0)

              Serious - Use Alternative (15)

              • baloxavir marboxil

                iron dextran complex will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

              • benazepril

                benazepril increases toxicity of iron dextran complex by Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. ACE Inhibitors may enhance adverse/toxic effect of iron dextran complex, specifically anaphylactic reactions.

              • captopril

                captopril increases toxicity of iron dextran complex by Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. ACE inhibitors may enhance the adverse/toxic effect of iron dextran complex, specifically anaphylactic type reactions.

              • demeclocycline

                iron dextran complex decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • doxycycline

                iron dextran complex decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • eltrombopag

                iron dextran complex decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.

              • fleroxacin

                iron dextran complex decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • gemifloxacin

                iron dextran complex decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • levofloxacin

                iron dextran complex decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • minocycline

                iron dextran complex decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • moxifloxacin

                iron dextran complex decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • mycophenolate

                iron dextran complex decreases levels of mycophenolate by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Interaction only with oral iron administration.

              • ofloxacin

                iron dextran complex decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • oxytetracycline

                iron dextran complex decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • tetracycline

                iron dextran complex decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              Monitor Closely (31)

              • aluminum hydroxide

                aluminum hydroxide will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • calcium carbonate

                calcium carbonate will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cimetidine

                cimetidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ciprofloxacin

                iron dextran complex decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Coadministration of ciprofloxacin with multivalent cation-containing products may reduce the bioavailability of ciprofloxacin by 90%. Administer ciprofloxacin at least 2 hours before or 6 hours after using these products. Use alternatives if available.

              • deferasirox

                deferasirox decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferasirox chelates iron.

              • deferiprone

                iron dextran complex decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

              • deferoxamine

                deferoxamine decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron.

              • dexlansoprazole

                dexlansoprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • didanosine

                didanosine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration

              • esomeprazole

                esomeprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • famotidine

                famotidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ibandronate

                iron dextran complex decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ibuprofen/famotidine

                ibuprofen/famotidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • lansoprazole

                lansoprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • levodopa

                iron dextran complex decreases levels of levodopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Oral administration of iron salts should be separated from levodopa by at least 2 hours.

              • levothyroxine

                iron dextran complex decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • liothyronine

                iron dextran complex decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • methyldopa

                iron dextran complex decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • nizatidine

                nizatidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • omadacycline

                iron dextran complex will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • omeprazole

                omeprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • pantoprazole

                pantoprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • penicillamine

                iron dextran complex decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Interaction only with oral iron administration.

              • rabeprazole

                rabeprazole will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sarecycline

                iron dextran complex will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

              • sodium bicarbonate

                sodium bicarbonate will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium citrate/citric acid

                sodium citrate/citric acid will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • thyroid desiccated

                iron dextran complex decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • trientine

                trientine, iron dextran complex. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hr.

              Minor (9)

              • calcium acetate

                calcium acetate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                iron dextran complex increases levels of calcium acetate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium carbonate

                calcium carbonate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                iron dextran complex increases levels of calcium carbonate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium chloride

                calcium chloride decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                iron dextran complex increases levels of calcium chloride by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium citrate

                calcium citrate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                iron dextran complex increases levels of calcium citrate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium gluconate

                calcium gluconate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                iron dextran complex increases levels of calcium gluconate by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • carbidopa

                iron dextran complex decreases levels of carbidopa by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • gymnema

                gymnema decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • manganese

                iron dextran complex decreases levels of manganese by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • vitamin E

                vitamin E decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Abdominal pain

              Diarrhea

              Nausea

              Vomiting

              Arthralgia

              Arthritis

              Soreness

              Inflammation

              Pruritus

              Rash

              Urticaria

              Brown discoloration of skin

              Frequency Not Defined

              Seizure

              Chest pain

              Hypotensive shock

              Dyspnea

              Respiratory arrest

              Leukocytosis

              Anaphylaxis

              Hematuria

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              Warnings

              Black Box Warnings

              Anaphylactic type reactions, sometimes fatal, have occurred with parenteral use of this product.

              Have resuscitation equipment and personnel trained in detection and treatment of anaphylactic-type reactions readily available during administration.

              Administer a test dose prior to first therapeutic dose; if no signs or symptoms of anaphylactic-type reactions follow the test dose, administer the full therapeutic dose

              During all administrations, observe for signs or symptoms of anaphylactic-type reactions; fatal reactions reported following test dose of iron dextran injection; fatal reactions have also occurred in situations where test dose was tolerated

              Use drug only in patients in whom clinical and laboratory investigations have established an iron-deficient state not amenable to oral iron therapy

              Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions to drug

              Contraindications

              History of hypersensitivity to product or excipients

              Cautions

              Iron overload

              • Excessive therapy with parenteral iron can lead to excess storage of iron with the possibility of iatrogenic hemosiderosis
              • All adult and pediatric patients receiving drug require periodic monitoring of hematologic and iron parameters (hemoglobin, hematocrit, serum ferritin and transferrin saturation); do not administer drug to patients with evidence of iron overload

              Risk of toxicity in patients with underlying conditions

              • Monitor for iron toxicity when drug is used in patients with serious impairment of liver function
              • May increase pathogenicity of certain microorganisms; product should not be used during acute phase of infectious kidney disease
              • Adverse reactions experienced following administration of drug may exacerbate cardiovascular complications in patients with pre-existing cardiovascular disease
              • Patients with rheumatoid arthritis may have an acute exacerbation of joint pain and swelling following the administration of iron dextran
              • Patients with history of significant allergies and/or asthma may have increased risk of hypersensitivity reactions

              Delayed reactions

              • Large intravenous doses, such as used with total dose infusions (TDI), associated with increased incidence of adverse reactions
              • Adverse reactions are frequently delayed (1 to 2 days) reactions typified by one or more of the following symptoms: arthralgia, backache, chills, dizziness, moderate to high fever, headache, malaise, myalgia, nausea, and vomiting
              • The onset is usually 24 to 48 hours after administration and symptoms generally subside within 3 to 4 days; etiology of reactions is not known; do not exceed a total daily dose of 2 mL undiluted iron dextran

              Hypersensitivity reactions

              • Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, reported following parenteral administration of iron dextran products
              • Such reactions have been generally characterized by sudden onset of respiratory difficulty and/or cardiovascular collapse; fatal reactions reported following the test dose of iron dextran and have also occurred in situations where test dose was tolerated
              • Administer only in a setting where resuscitation equipment and medications are available; administer test dose prior to first therapeutic dose; observe patients for at least one hour after test dose before administering remainder of initial therapeutic dose
              • During all product administrations, observe patients for signs or symptoms of anaphylactic-type reactions
              • Use drug only in patients in whom clinical and laboratory investigations have established an iron deficient state not amenable to oral iron therapy
              • Factors that affect risk for anaphylactic-type reactions to iron dextran products are not fully known but limited clinical data suggest risk may be increased among patients with history of drug allergy or multiple drug allergies; additionally, concomitant use of angiotensin-converting enzyme inhibitor drugs may increase risk for reactions to an iron dextran product
              • The extent of risk for anaphylactic-type reactions following exposure to any specific iron dextran product is unknown and may vary among products; if hypersensitivity reactions occur during administration, stop infusion immediately and manage reaction medically
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              Pregnancy & Lactation

              Pregnancy

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

              Severe adverse reactions including circulatory failure (severe hypotension, shock including in the context of anaphylactic reaction) may occur in pregnant women with parenteral iron products, which may cause fetal bradycardia, especially during second and third trimester

              Animal data

              • 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 maximum human dose; no consistent adverse fetal effects were observed in mice, rats, rabbits, dogs and monkeys at doses of 50 mg iron/kg or less
              • Fetal and maternal toxicity has been reported in monkeys at a total intravenous dose of 90 mg iron/kg over a 14-day period; similar effects were observed in mice and rats on administration of a single dose of 125 mg iron/kg; fetal abnormalities in rats and dogs were observed at doses of 250 mg iron/kg and higher; the animals used in these tests were not iron deficient

              Lactation

              Exercise caution when product is administered to a nursing woman; traces of unmetabolized iron dextran are excreted in human milk

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin

              Pharmacokinetics

              Half-Life: 6 hr

              Onset: 7-9 days (serum ferritin peak)

              Peak Plasma Time: 10 days

              Absorption: Within 72 hr (IM)

              Excretion: Minimal through urine and feces

              Dialyzable: No

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              Administration

              IV Preparation

              Standard diluent: Dose/250-1000 mL 0.9% NaCl

              Minimum volume: 250 mL 0.9% NaCl

              IV Administration

              IV may be administered bolus at <50 mg/min or diluted in 250-1000 mL 0.9% NaCl

              Infuse over 1-6 hr; infuse initial 25 mL slowly

              Observe for allergic reactions; have epinephrine nearby

              IM Administration

              IM: Use z-track technique for IM administration (deep into upper outer quadrant of buttock)

              Observe for allergic reactions; have epinephrine nearby

              Storage

              Store at room temp

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Infed injection
              -
              50 mg/mL vial
              Infed injection
              -
              50 mg/mL vial
              Infed injection
              -
              50 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              iron dextran injection

              IRON DEXTRAN - INJECTION

              (EYE-urn DEX-tran)

              COMMON BRAND NAME(S): Dexferrum, INFeD

              WARNING: Rarely, iron dextran for injection has caused severe (sometimes fatal) allergic reactions. It should be used only when clearly needed and when a patient is unable to take iron by mouth (oral forms).Tell your doctor right away if you experience signs of an allergic reaction such as trouble breathing, dizziness, rash, or itchy skin.

              USES: This medication is used to treat "iron-poor" blood (anemia) in people who cannot take iron by mouth because of side effects or because their anemia has not been successfully treated by it. Low iron levels can occur when the body can't get enough iron from food (poor nutrition, poor absorption) or when there is a large or long-term blood loss (for example, due to hemophilia, stomach bleeding). It is also used by people who have anemia due to long-term kidney disease.Iron is an important part of your red blood cells and is needed to carry oxygen in the body.

              HOW TO USE: This medication is usually injected deep into the muscle of the buttock or slowly into a vein as directed by your doctor. When injecting into the buttock, the next injection is given on the opposite side from the last injection.Before the first full dose, a smaller test dose is given slowly to check for possible allergic effects. If no reaction is seen after one hour, the full dose may be given. You will be checked carefully for reactions by a health care worker each time you are getting the iron.Iron injections may be given once daily in small doses or as directed by your doctor. Large doses may be given in a solution and injected into a vein over several hours. Some side effects such as dizziness and flushing may be stopped by giving the drug more slowly. The dose and length of treatment is based on your age, weight, condition, and response to therapy. Your doctor will order blood tests to monitor your response.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

              SIDE EFFECTS: Flushing, tingling of the hands/feet, shivering, or dizziness may occur. The area around the injection site may be tender, irritated, or discolored (brown). If any of these effects persist or worsen, contact your doctor or pharmacist promptly.Some people may experience a delayed reaction 1-2 days after their treatment. These side effects usually lessen within 3 to 4 days if the medication was injected into a vein or within 3 to 7 days if the medication was injected into a muscle. Tell your doctor if any of these side effects persist or worsen more than 4 to 7 days after your treatment: back/joint/muscle aches, chills, moderate to high fever, headache, nausea/vomiting.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: abdominal pain, fast/slow/irregular heartbeat, severe headache, blurred vision.Get medical help right away if any of these rare but very serious side effects occur: chest pain, seizures.A very serious allergic reaction to this drug may occur. Get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: low blood count not due to low iron (e.g., vitamin B12/folate deficiency), active kidney infection.Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe allergic reactions, asthma, bleeding problems (e.g., hemophilia), heart disease (e.g., chest pain, heart attack, heart failure), Hodgkin's disease, autoimmune disease (e.g., rheumatoid arthritis, ankylosing spondylitis, lupus), kidney disease/dialysis, liver disease.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: other iron products.This medication may interfere with certain laboratory tests (including bilirubin, calcium, and clotting times), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Laboratory and/or medical tests (e.g., complete blood count, iron) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.It is important to maintain a well-balanced diet to ensure adequate intake of iron, vitamins, and minerals. Good sources of iron include meats (especially liver), eggs, raisins, figs, broccoli, Brussels sprouts, beans, lentils, and iron-fortified or enriched cereals. Follow any diet recommendations given to you by your doctor.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

              STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.