Iron Dextran is on the inpatient formulary, for patients requiring a large IV iron dose in one administration.  For lower doses and patients admitted for multiple days, the preferred inpatient product, ferric gluconate, should be used (exception pediatrics and pregnant or breast-feeding women).

Standard practice at Legacy is to omit a test dose for iron dextran.  There is a low risk of hypersensitivity reactions with IV iron products and administration of a test dose may give false reassurance. 

If extravasation occurs, please refer to Elsevier Clinical Skills: Prevention and Management of Extravasations for the Treatment and Management of Extravasations

See the IV Iron Algorithm for details on administration of IV iron in the inpatient setting.  This algorithm includes possible infusion reactions and their classifications.

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