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Case report
Iron III isomaltose induced hypersensitivity reaction
  1. Mahreen Muzammil1,2,
  2. Kashif Aziz3,
  3. Muhammad Ehteram ul Haq4 and
  4. Nosheen Nasir3
  1. 1 Department of Pharmacy Services, Aga Khan University, Karachi, Pakistan
  2. 2 Department of Pharmacology, Faculty of Pharmacy, Jinnah University for Women, Karachi, Pakistan
  3. 3 Department of Medicine, Aga Khan University, Karachi, Pakistan
  4. 4 Post Graduate Medical Education, Aga Khan University, Karachi, Pakistan
  1. Correspondence to Mahreen Muzammil; mahreen.muzammil{at}


Iron isomaltose is considered as safe form of iron with no test dose recommended. Here, we are describing the case of a patient who experienced allergic reaction with this formulation of iron. A 35-year-old South Asian woman experienced allergic reaction, she had mild wheeze on examination of chest. She was given intranasal oxygen at 2 L/min. She was given intravenous acetaminophen 1 g for pain relief, 45.4 mg intravenous chlorphenaramine and intravenous 100 mg hydrocortisone. Within half an hour, all her symptoms improved and her hypoxia resolved. Her chest wheezing also disappeared. Iron isomaltose, although relatively safe, can cause allergic reaction. Intravenous iron can cause allergic reaction therefore it should be administered at the facility where trained staff is present so that necessary treatment can be given in case of hypersensitivity reaction.

  • drug interactions
  • unwanted effects / adverse reactions

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  • Contributors KA witnessed the case, provided immediate care and contributed to data gathering. NN managed the case, provided expert opinion and reviewed the manuscript. MEH arranged writeup. MM point of care pharmacist for patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.