Parenteral administration of iron dextran may be associated with serious, adverse side effects. However, there are specific indications for parenteral administration for iron replacement.


(1) intolerance to oral replacement due to intractable gastrointestinal side effects, not controllable by dosage modifications

(2) iron malabsorption

(3) iron needs that cannot be met by the oral route due to recurrent, uncontrollable blood loss

(4) hemodialysis patients unable to keep up with increased iron needs by oral replacement


Drugs which may interfere with iron absorption:

(1) antacids

(2) histamine-2 blockers

(3) proton pump inhibitors

(4) levodopa


Patients with a partial gastrectomy may absorb oral iron poorly if taken with food, but may absorb adequately if the iron is taken between meals.


Iron malabsorption may be seen in patients with:

(1) total gastrectomy

(2) extensive resection of the upper small intestine

(3) celiac sprue

(4) other diseases of the upper small intestine

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