While oral iron supplementation is the primary strategy for treating iron-deficiency anemia, it may be ineffective for some individuals due to intolerance, impaired absorption, substantial continuous bleeding, or nonadherence.

For these patients, intravenous iron supplementation may be indicated.

In this study, researchers evaluated the incidence of anaphylaxis, a potentially fatal allergic reaction, among patients who received one of the five most commonly used IV iron solutions to treat iron shortages.

While their efficiency has been proven, the most dangerous and fatal side effect is the risk of anaphylaxis (an allergic reaction to a drug), which can occur during the first and subsequent exposures.

According to the article’s, the relative safety of each product has not been properly proven.

IV iron dextran, gluconate, sucrose, or ferumoxytol were investigated in this study. At the time of the initial exposure, 274 cases of anaphylaxis were recognized, with an additional 170 cases identified after subsequent IV iron infusions.

When compared to nondextran formulations, the researchers discovered that iron dextran was linked to a higher risk of anaphylaxis at first administration.

Both iron gluconate and ferumoxytol had a higher risk of anaphylaxis at first administration than iron sucrose among the nondextran formulations.

Because each IV iron product has a different recommended dose and administration schedule, the total risk of anaphylaxis was determined based on the number of administrations as well as the clinically relevant iron repletion level (1000 mg) obtained within 12 weeks.

In both trials, iron dextran was linked to the highest cumulative risk of anaphylaxis, while iron sucrose was linked to the lowest risk.

The mechanism of anaphylactic reaction following IV iron is unknown, according to scientists.

Source: 10.1001/jama.2015.15572

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