Iron(III)-hydroxide dextran complex in CosmoFer injection has a very low toxicity. The preparation is well tolerated and has a minimal risk of accidental overdosing.
Overdose can cause acute iron overloading which may manifest itself as haemosiderosis. Supportive measures such as iron chelating agent can be used.
With chronic repeated administration of iron at high dose, the excess iron will accumulate in the liver and induce an inflammatory process, which may lead to fibrosis.