Symptoms of iron overdosage may be present when 20 mg/kg is ingested. Acute poisoning will produce symptoms like abdominal pain, diminished tissue perfusion, fever, dyspnea, hyperglycemia, hypotension, lethargy, leukocytosis, metabolic acidosis, nausea, blackened stools, vomiting, rapid pulse, and/or comatose. If not immediately fatal, symptoms may subside within 12 to 24 hours. Symptoms may return in 12 to 48 hours after ingestion and may include the following: anuria, convulsion, death, diffuse vascular congestion, hyperthermia, metabolic acidosis, pulmonary edema, shock.
Treatment of Overdosage: Maintain proper airway, respiration, and circulation. Perform gastric lavage in patients who are candidates for GI decontamination. Systemic chelation therapy with deferoxamine is generally recommended for patients with serum iron levels greater than 350 to 500 mcg/dL or in patients with symptoms of iron toxicity.