Iron sorbitol

Manufacture of vitamin C starts with the conversion of sorbitol to L-sorbose. Sorbitol and xyHtol have been used for parenteral nutrition following severe injury, bums, or surgery (246). An iron—sorbitol—citric acid complex is an intramuscular bematinic (247). Mannitol administered intravenously (248) and isosorbide administered orally (249) are osmotic diuretics. Mannitol hexanitrate and isosorbide dinitrate are antianginal dmgs (see Cardiovascular agents). 

Iron trivalent, parenteral preparations iron-sorbitol-citric acid complex... 

Parenteral preparations Iron dextran (IMFERON) Iron-sorbitol citric acid complex (JECTOFER). 

Iron sorbitol-citric acid complex Isatidine... 

There was severe phlebitis in cancer patients receiving deferoxamine (50 mg/kg/day by intravenous infusion over 72 hours) and iron sorbitol citrate in an attempt to enhance doxorubicin activity (18). Dilution of the drug in large volumes of saline did not prevent this adverse effect. 

Voest EE, Neijt JP, Keunen JE, Dekker AW, van Asbeck BS, Nortier JW, Ros FE, Marx JJ. Phase I study using desferrioxamine and iron sorbitol citrate in an attempt to modulate the iron status of tumor cells to enhance doxorubicin activity. Cancer Chemother Pharmacol 1993 31(5) 357-62. 

Iron compounds for intramuscular administration are iron sorbitol-citric acid complex (iron sorbitex), iron dextran, iron glycerin-citric acid complex, and iron poljdso-maltose. The work on these formulations is largely old and has been reviewed in previous volumes in this series. 

Iron toxicity can be expected if the amount of free iron released into the plasma exceeds the plasma iron-binding capacity. This is more likely to occur when using iron sorbitol-citric acid complex (iron sorbitex), since the iron is less firmly bound than with iron dextran. Several conditions associated with low iron-binding capacity, such as malnutrition (kwashiorkor, malnutrition syndrome) and previous or simultaneous oral iron therapy appear to predispose to the development of these toxic reactions. In addition, folic acid deficiency has been reported to be a predisposing factor (SED-9, 516), the likely mechanism being altered iron utilization secondary to folic acid deficiency, which results in an increased saturation of ironbinding capacity. 

Urine can turn dark in color in the first 24 hours after parenteral iron injection. The reddish-brown color, which has been observed after the intramuscular injection of iron sorbitol-citric acid complex (SED-8, 515), is due to urinary excretion of part of the iron compound. It has to be distinguished from the black discoloration that may develop if urine of patients who have received iron-sorbitex is allowed to stand, assumed to be due to production of iron sulfide by bacterial growth. Phenomena of this kind are unhkely to occur after the... 

Scott JM. Iron-sorbitol-citrate in pregnancy anaemia. BMJ 1963 5353 354-7. 

Lindvall S, Andersson NSE. Studies on a new intramuscular haematinic, iron-sorbitol. Br ] Pharmacol 1961 17 358-371. 

Injectable iron preparations Iron sorbitol injection 5% iron sorbitol (50 mg Fe ml )... 

Too high concentrations of the active compound at the injection site (initial peak concentrations) are avoided in masking the irritating agent through complexation. The free concentrations of iron or of calcium are reduced in using calcium gluconate or levulinate for intravenous injections and iron-sorbitol citrate for intramuscular injections. ... 

Iron sorbitol is a complex of iron, sorbitol and citric acid. It i.s not suitable for intravenous injection and is given by deep intramuscular injcction.s to minimi/c staining of the skin. Iron sorbitol may cause anaphylactoid reactions. Iron sucrose is a complex of ferric hydroxide with sucrose that is given by intravenous injection or infusion. Severe reactions may occur and drugs for resuscitation and anaphylaxis should be available. 

Ferrous salts are absorbed more efficiently than ferric salts and are given in the treatment of iron-deficiency anaemia. They are not, however, always well tolerated and it is sometimes necessary to give special preparations, e.g. iron-dextran or iron-sorbitol parenterally. 

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