If two patients receive IV iron from the same bag and at the same rate, will both have a reaction?

No. These reactions are largely patient-dependent, not product-dependent.

• A complement-activation reaction (sometimes called a Fishbane reaction) reflects an individual’s innate sensitivity to nanoparticle iron complexes, which can vary widely between patients.
• Factors such as baseline complement reactivity, underlying inflammation, genetic differences, or even anxiety and catecholamine tone can influence who reacts.
• So if patient A develops flushing or chest tightness, it doesn’t mean there’s anything wrong with the bag or that patient B will react too.
• Each infusion is essentially a new “test” of the patient’s own physiology — not of the product itself.