This document summarizes information on several medications: Iron dextran and iron sucrose injections are contraindicated in patients with allergies or infections and should be avoided during pregnancy. They can cause side effects like flushing, shortness of breath, and rash. High doses of vitamin B6 for extended periods can cause sensory neuropathy. Vitamin B12 injections are associated with dizziness, fever, and hypersensitivity reactions. Vitamin K injections are recommended for newborns to prevent bleeding and should be given orally to breastfed babies. Erythropoietin and methoxy polyethylene glycol are used to treat anemia but can increase blood pressure and risk of blood clots

1. REFERENCE:BNF 73 1
I. Iron dextran (50mg/ml)
* contraindicated in history of allergic disorder like asthma & eczema,
infections, active rheumatoid arthritis
* should be avoided in severe hepatic impairment, acute renal failure & 1st
trimester of pregnancy
* oral tratment started least 5 days after last injection
* less commonly associated with flushing, dyspnoea, numbness, cramps,
blurred vision, pruritus & rash
* rarely causes hypotension, angioedema, arrythmias, dizziness, fatigue,
tremor, seizures, impaired consciousness, myalgia, arthralgia & sweating
II. Iron sucrose (20mg/ml)
* countraindicated in history of allergic disorders: asthma, eczema &
anaphylaxis
* used with caution in hepatic impairment (iron overload increases risk) &
should be avoided in pregnancy
* oral tratment started least 5 days after last injection
* associated with taste disturbance & less commonly flushing, dyspnoea,
bronchospasm, dizziness, fever, myalgia, pruritus, rash & injection site
reactions
* rarely causes hypertension, peripheral oedema, anaphylactic reactions,
fatigue, asethnia, arthralgia, confusion & sweating

2. REFERENCE:BNF 73 2
III. Vitamine B6
* sensory neuropathy is reported with high dose (200mg or more daily) or
extended periods regimen
IV. Vitamine B12
* hydroxocobalamine is associated with dizziness, fever, hypersensitivity
reactions, hyokalaemia, thrombocytosis & chromaturia
V. Vitamine K
* The Chief Medical/Nursing Officer recommended that all newborn babies
shoud receive single 1mg I.M injection to prevent vit. K defeciency bleeding
otherwise colloidal preparation given by mouth as 2mg in 1st week ( 1st dose
at birth & 2nd dose at 4-7 days & A 3rd dose at 1month of age for exclusively
breast-fed babies)
* Intravenous injection should be given very slowly
VI. Erythropoietin-α & Methoxy polyethylene glycol
* used in caution with ischemic vascular disease, poorly controlled blood
pressure (dose dependent increase in blood pressure-sudden stabbing
migraine like pain indicate hypertensive crisis, also risk of thrombosis), so
avoidance recommended with recent MI/CVA, generlized tonic-clonic
seizures & encephalopathy like symptoms
* used in caution with chronic hepatic failure
*used in caution with malignant disease (risk of tumour progression), while
in pt. receiving chemotherapy (associated with increased risk thrombosis)
* associated with risk of red cell aplasia-particularly after S.C administration
(contra-indicated; all erythropoetin forms)
* associated with hyperkalemia, hypersensity reactions, skin reaction &
peripheral edema
* no evidence of harm reported during pregnancy neither in breast feeding (
unlikely to present in milk)
* avoided in neonates receiving benzyl alcohol containing injections, also
associated with retinopathy when used in prenature infants
* Hb concentration should be maintained within 10-12g/100ml

3. REFERENCE:BNF 73 3
* Methoxy polyethylene glycol has longer duration of action than
erythroboetin
* Methoxy polyethylene glycol used in caution with pregnancy & breast-
feeding (stated bymanufacturer despite no evidence ofharm & present in milk
in animal-studies respectively)