Intravenous iron administration and management of adverse events: a systematic review and Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis consensus recommendations

Intravenous iron therapy is an established component in the management of iron deficiency and iron-deficiency anaemia. However, it is often underused, often because of the fear of potential adverse events. Therefore, its use necessitates rigorous and systematic evaluation of safety considerations. This NATA (Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis) consensus recommendation summarises current evidence on the most relevant adverse events associated with i.v. iron administration, including hypersensitivity and infusion reactions, hypophosphataemia, extravasation and potential infection risk. Based on the available evidence, we provide practical recommendations for adverse events diagnosis, risk mitigation, patient counselling, and formulation selection to optimise the safe and effective use of i.v. iron for treatment and prevention of anaemia in routine clinical practice.