The Treatment of Iron-deficiency Anemia with Intravenous Iron Dextran.

I N THE THERAPY of iron-deficiency anemia, iron given orally is safe, effective, inexpensive, and is usually the treatment of choice, but occasionally when a rapid replenishment of iron stores is desired, administration by the parenteral route is indicated. Heath, Strauss and Castle,1 in 1938, showed that when 16-32 mg. of iron as ferric ammonium citrate is injected subcutaneously or intramuscularly, practically the total amount is utilized for hemoglobin formation. Two iron compounds, iron ascorbate2 and colloidal ferric hydroxide, have been given intravenously in doses of 10 mg., but both proved to be unstable and toxic. The introduction of saccharated iron oxide4 and dextriferron ( iron dextrin ) 5 about 15 years ago provided improved preparations for intravenous use, for as much as 500 mg. could be injected without causing serious toxic reactions. In 1954, a new compound, iron-dextran complex ( Imferon ) , was found to be effective when given intramuscularly.6 Most published accounts have dealt with intramuscular administration of this preparation. In one of the few reports on the intravenous use of iron dextran, Callender and Smith7 described toxic reactions in two patients who had been given 50 mg. parenterally, and suggested further study of its administration by the intravenous route. The present investigation deals with the intravenous use of iron-dextran in very large amounts in 45 patients. Most of the injected iron stayed in the blood stream for several hours, was well tolerated and eventually utilized. A preliminary report has been published.8