Железо при внутримышечном введении очень медленно и не полностью всасывается, поэтому и гемоглобин растет лишь чуть быстрее, чем при приеме пероральной формы. Плюс опять-таки местные побочные эффекты.
Подробнее:
Intramuscular iron*—*Mobilization of iron from intramuscular sites is slow and occasionally incomplete. As a result, the rise in the hemoglobin concentration is only slightly faster then that which occurs following the use of oral iron preparations.
Patients who have very brisk continuing bleeding (as with gastrointestinal angiodysplasia) are difficult to treat with an intramuscular (IM) regimen because repeated courses of IM iron are painful, and the utilization of iron given IM is variable. Patients with severe malabsorption and/or malnutrition may not be candidates for IM treatment if they have a markedly reduced muscle mass into which the iron preparation can be injected.
For all of the above reasons, including the fact that IM administration of iron dextran has not been shown to be safer or less toxic than the IV route, the most appropriate parenteral route is the intravenous one [11].
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