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For further information, see CMDT Part 40-37: Iron Overdose
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Most adult preparations contain 60–90 mg of iron per dose
Iron is corrosive to the gastrointestinal (GI) tract
Intracellular toxic effects of iron include disruption of Krebs cycle enzymes
Carbonyl iron
Powdered form of elemental iron
Not as irritating to the GI tract as the iron salts, and appears to be safer
Excessive circulating free iron has depressant effects on myocardium and on peripheral vascular resistance
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Ingestion of < 30 mg of iron per kg of body weight usually produces only mild GI upset
Ingestion of > 40–60 mg/kg may cause
Vomiting
Hematemesis
Diarrhea
Hypotension
Metabolic acidosis
Death may occur from
Acute liver failure may occur
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Serum iron levels > 350–500 mcg/dL are potentially toxic
Serum levels > 1000 mcg/dL usually associated with severe poisoning
Plain abdominal radiograph may reveal radiopaque tablets
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Emergency and supportive measures
Treat hypotension aggressively with intravenous crystalloid solutions (0.9% saline or lactated Ringer solution)
Perform whole-bowel irrigation to remove unabsorbed pills, particularly when intact tablets are visible on abdominal radiograph
Deferoxamine
For symptomatic toxicity, and particularly with markedly elevated serum iron levels (eg, > 800–1000 mcg/dL)Activated charcoal is not effective