There are no adequate and well-controlled trials of CosmoFer in pregnant women. Studies in animals have shown reproductive toxicity. A careful risk/benefit evaluation is therefore required before use during pregnancy and CosmoFer should not be used during pregnancy unless clearly necessary.
Iron deficiency anaemia occurring in the first trimester of pregnancy can in many cases be treated with oral iron. Treatment with CosmoFer should be confined to second and third trimester if the benefit is judged to outweigh the potential risk for both the mother and the foetus.
It is unknown whether the complex iron-dextran is excreted in human or animal breast milk. It is preferable to not use CosmoFer during breast-feeding.