Oct

11

2025

How common are serious reactions today?

By William Aird

  • Serious hypersensitivity reactions to modern IV iron formulations are exceedingly rare. Large pharmacovigilance studies estimate anaphylaxis in fewer than 1 per 200,000 infusions, with no fatalities reported for current low-molecular-weight or non-dextran preparations.
  • Mild, transient reactions (such as flushing or chest tightness—so-called Fishbane reactions) occur in about 1–3% of infusions and usually resolve within minutes when the infusion is paused.
  • The discontinuation of high-molecular-weight iron dextran has made IV iron one of the safest parenteral therapies used in clinical practice.