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Acute, severe and anaphylactoid reactions are very rare with low-molecular-weight iron dextran, CosmoFer®

Nephrology Dialysis Transplantation
Oxford University Press
Publication Date
DOI: 10.1093/ndt/gfn251
  • Letters And Replies
  • Medicine
  • Pharmacology


letters.dvi 3372 Nephrol Dial Transplant (2008) 23: 3372 1. Block GA, Zeig S, Sugihara J et al. Combined therapy with cinacalcet and low doses of vitamin D sterols in patients with moderate to severe secondary hyperparathyroidism. Nephrol Dial Transplant 2008; 1–8 2. Goodman WG, Frazao JM, Goodkin DA et al. A calcimimetic agent lowers plasma parathyroid hormone levels in patients with secondary hyperparathyroidism. Kidney Int 2000; 58: 436–445 3. Cunningham J, Danese M, Olson K et al. Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidism. Kidney Int 2005; 68: 1793–1800 4. USRDS. 2007. Annual Data Report: 2007; adr.htm 5. Foley RN, Li S, Liu J et al. The fall and rise of parathyroidectomy in U.S. hemodialysis patients, 1992 to 2002. J Am Soc Nephrol 2005; 16: 210–218 doi: 10.1093/ndt/gfn425 Advance Access publication 29 May 2008 Acute, severe and anaphylactoid reactions are very rare with low-molecular-weight iron dextran, CosmoFer R© Sir, It was with interest and surprise that I read the article by Liliana Schaefer and Roland M Schaefer [1]. In this article, Liliana and Roland Schaefer do not dis- tinguish between the adverse drug event profile of the old high-molecular-weight iron dextrans that have been with- drawn from the market of Europe ∼20 years ago and the low-molecular-weight iron dextran marketed in 1992 as INFeD R© in the US and in 2001 as CosmoFer R© in Europe and overseas. The product is produced by Pharmacosmos in Denmark and marketed in more than 40 countries. Numerous articles, [2–7], including the Chertow arti- cle [5] referenced by the Schaefers, document that the high-molecular-weight iron dextran has many times more adverse drug events than the low-molecular-weight iron dextran. The high-molecular-weight iron dextran is today marketed practically only in the USA under the brand Dex- ferrum where the active pharmaceutical ingredient is pro-

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