Anaphylactic-type reactions might occur. Delayed infusion reaction (including arthralgia, back pain, chills, dizziness, and fever) might occur with large doses (e.g. total dose infusion) of I.V. iron dextran. May also occur (less commonly) with intramuscular administration. Use with caution in significant history of allergies or asthma. I.M. administration not recommended for parenteral iron supplementation. Use with caution in pre-existing cardiovascular disease (iron dextran might exacerbate cardiovascular complications). Use with extreme caution in serious hepatic impairment. Either oral iron or intravenous iron may be used for nondialysis and peritoneal dialysis chronic kidney disease patients. Avoid use during acute kidney infection. Use with caution in rheumatoid arthritis (might exacerbate joint pain and swelling). I.V. administration of iron dextran often preferred in the elderly. Not recommended in children under 4 months of age. Possible risk of delayed injection site tumor development. Exogenous hemosiderosis may result from excess iron stores.