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Why Different Iron(III)-oxyhydroxide Complexes have Different PK/PD Characteristics and Specific Reactivities

Peter Geisser

The review demonstrates that PK (pharmacokinetics) and a major part of PD (pharmacodynamics) of pn-iron(III)-oxyhydroxide carbohydrate complexes (pn-ICC) depend on the characteristics of the individual compounds that can be described as prodrugs and cannot be reduced to iron as active component only. Such an oversimplification can be a risk to the patients’ safety as the user might assume that all pn-ICC are more or less the same. This is clearly not the case as can be seen from the maximum allowed single daily dose, from the different pharmacovigilance and preclinical data. Moreover differences in efficacy were observed. As a result, it is neither helpful nor reasonable to reduce all pn-iron(III)-oxyhydroxide carbohydrate complexes to iron only.