Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management.

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Rampton D, Folkersen J, Fishbane S, Hedenus M, Howaldt S, Locatelli F, Patni S, Szebeni J, Weiss G

Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management.

Haematologica. 2014 Nov;99(11):1671-6. doi: 10.3324/haematol.2014.111492.

PubMed ID

25420283 [ View in PubMed

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Abstract

Intravenous iron is widely used for the treatment of iron deficiency anemia when oral iron is inappropriate, ineffective or poorly tolerated. Acute hypersensitivity reactions during iron infusions are very rare but can be life-threatening. This paper reviews their frequency, pathogenesis and risk factors, and provides recommendations about their management and prevention. Complement activation-related pseudo-allergy triggered by iron nanoparticles is probably a more frequent pathogenetic mechanism in acute reactions to current formulations of intravenous iron than is an immunological IgE-mediated response. Major risk factors for hypersensitivity reactions include a previous reaction to an iron infusion, a fast iron infusion rate, multiple drug allergies, severe atopy, and possibly systemic inflammatory diseases. Early pregnancy is a contraindication to iron infusions, while old age and serious co-morbidity may worsen the impact of acute reactions if they occur. Management of iron infusions requires meticulous observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff.

DrugBank Data that Cites this Article

Drugs

Ferric derisomaltose

Drug Interactions

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drugs	Interaction
Integrate drug-drug interactions in your software
Benazepril Iron	The risk or severity of adverse effects can be decreased when Iron is combined with Benazepril.
Captopril Iron	The risk or severity of adverse effects can be decreased when Iron is combined with Captopril.
Cilazapril Iron	The risk or severity of adverse effects can be decreased when Iron is combined with Cilazapril.
Enalapril Iron	The risk or severity of adverse effects can be decreased when Iron is combined with Enalapril.
Enalaprilat Iron	The risk or severity of adverse effects can be decreased when Iron is combined with Enalaprilat.