Is iron gluconate really safer than iron dextran?
Parenteral supplementation of iron is required in some patients with iron deficiency, including those with oral iron intolerance, chronic uncorrected bleeding, malabsorption, gastrointestinal inflammatory disease, dialysis dependence, or failure to take prescribed oral iron. A more rapid increase in hemoglobin production occurs after intravenous administration, which may be valuable in anemic patients and chronic bleeding patients. Unlike oral iron, the full dose of intravenous iron is delivered to the bone marrow and saturates tissue stores.1,2 The 2 popular forms of available parenteral iron in the United States are iron dextran and iron gluconate. Despite their value, intravenous iron therapy carries the potential for serious allergic reactions. In 1980, Hamstra et al examined over 2000 infusions of iron dextran among 481 patients and reported that 26% of patients experienced side effects, of which the majority were mild and self-limited. Of the reactions, 2% were considered “severe
