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Iron dextran Injection and Prestalia

Determining the interaction of Iron dextran Injection and Prestalia and the possibility of their joint administration.

Check result:
Iron dextran Injection <> Prestalia
Relevance: 24.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

If you are currently being treated with perindopril, you should talk to your doctor before receiving iron dextran. Medications like perindopril may occasionally increase the side effects of iron dextran such as allergic reactions, low blood pressure, lightheadedness, fever, flushing, chest pain, back pain, rash, itching, nausea, vomiting, diarrhea, and abdominal pain. Allergic reactions to iron dextran may be serious and potentially life-threatening; therefore, you must be closely monitored by your doctor while you are receiving the medication. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR CLOSELY: Limited data suggest that ACE inhibitors may increase the risk of systemic adverse effects associated with the use of iron dextran. The exact mechanism of interaction is unclear. Certain systemic reactions stemming from parenteral iron therapy are thought to be mediated by inflammatory substances such as bradykinin in response to iron-catalyzed generation of toxic free radicals. Since ACE inhibitors decrease the breakdown of kinins, it is conceivable that they may potentiate these reactions. Anaphylactic-type reactions, including fatalities, have followed the parenteral administration of iron dextran. Such reactions occur most often within the first several minutes of administration and are generally characterized by sudden onset of respiratory difficulty and/or cardiovascular collapse. The extent of risk for anaphylactic-type reactions following exposure to any specific iron dextran product is unknown, but may vary among the products due to differences in chemical characteristics. Other systemic adverse effects reported with iron dextran include hypotension, flushing, dizziness, headache, chest pain, cardiac arrest, arthralgia, myalgia, back pain, fever, chills, pruritus, rash, nausea, vomiting, diarrhea, and abdominal pain. The noncardiovascular reactions are frequently delayed by 24 to 48 hours after administration and subside within 3 to 4 days.

MANAGEMENT: Patients should be closely monitored during and after parenteral administration of iron dextran, regardless of whether they are being treated with an ACE inhibitor. This is particularly important in patients with a history of drug allergy or multiple drug allergies or an immune/inflammatory condition such as systemic lupus erythematosus or rheumatoid arthritis. Resuscitation techniques and personnel trained in the detection and treatment of anaphylactic-type reactions should be readily available. Prior to the first therapeutic dose, a test dose corresponding to 25 mg iron should be injected gradually. Although anaphylactic reactions are usually evident within a few minutes, observe patients for at least one hour before administering the remainder of the therapeutic dose. Administration must be stopped immediately if signs of an anaphylactoid reaction are observed. Patients should also be closely monitored during each subsequent administration of iron dextran. Fatal reactions have occurred following the test dose and also in situations where the test dose was tolerated. Iron dextran should only be used in patients in whom clinical and laboratory investigations have established an iron-deficient state not amenable to oral iron therapy. According to some studies, non-dextran parenteral iron formulations may be associated with a lower risk of adverse effects, especially death and life-threatening reactions such as anaphylaxis, cardiac arrest, and respiratory depression.

References
  • Bailie GR, Clark JA, Lane CE, Lane PL "Hypersensitivity reactions and deaths associated with intravenous iron preparations." Nephrol Dial Transplant 20 (2005): 1443-9
  • Michael B, Coyne DW, Folkert VW, Dahl NV, Warnock DG "Sodium ferric gluconate complex in haemodialysis patients: a prospective evaluation of long-term safety." Nephrol Dial Transplant 19 (2004): 1576-80
  • Faich G, Strobos J "Sodium ferric gluconate complex in sucrose: Safer intravenous iron therapy than iron dextrans." Am J Kidney Dis 33 (1999): 464-70
  • Rolla G, Bucca C, Brussino L "Systemic reactions to intravenous iron therapy in patients receiving angiotensin converting enzyme inhibitor ." J Allergy Clin Immunol 93 (1994): 1074-5
  • Chertow GM, Mason PD, Vaage-Nilsen O, Ahlmen J "On the relative safety of parenteral iron formulations." Nephrol Dial Transplant 19 (2004): 1571-5
  • "Product Information. INFeD (iron dextran)." Schein Pharmaceuticals Inc, Florham Park, NJ.
  • Fishbane S, Kowalski EA "The comparative safety of intravenous iron dextran, iron saccharate, and sodium ferric gluconate." Semin Dial 13 (2000): 381-4
  • Michael B, Coyne DW, Fishbane S, et al. "Sodium ferric gluconate complex in hemodialysis patients: Adverse reactions compared to placebo and iron dextran." Kidney Int 61 (2002): 1830-1839
  • Chertow GM, Mason PD, Vaage-Nilsen O, Ahlmen J "Update on adverse drug events associated with parenteral iron." Nephrol Dial Transplant 21 (2006): 378-82
Iron dextran Injection

Generic Name: iron dextran

Brand name: DexFerrum, Infed

Synonyms: Iron dextran, Iron Dextran Complex

Prestalia

Generic Name: amlodipine / perindopril

Brand name: Prestalia

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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