Safety profile of iron polymaltose infusions

Objectives: Iron polymaltose infusions are one type of iron infusate used to treat iron deficiency used in countries such as Australia. We looked at the safety profile of this infusion at one metropolitan hospital in Melbourne, Australia and the associated demographics of those who had reactions.

Methods: A retrospective review of the medical records all adult patients who had an iron polymaltose infusion at Western Hospital over 12 months was performed. Basic demographics, infusion indication, starting hemoglobin and ferritin, vital signs and medical details of patients who had an adverse reaction were recorded.

Results: There were 1103 patients who had iron infusions in a 12-month review period between 2017 and 2018. Adverse drug reactions occurred in 2.7% of infusions with no mortalities. The most common reaction was urticaria. No cases of anaphylaxis were recorded; however, four cases were associated with marked hypotension which resolved with fluid resuscitation and cessation of the infusion. Overall, vital signs remained clinically stable pre and post-iron polymaltose infusions.

Conclusion: Iron polymaltose has a low rate of adverse drug reactions; yet, serious side-effects such as hypotension may occur. Perturbations in hemodynamics within the first 20 min suggest close monitoring is necessary in the initial stages of infusion.