Management of acute intravenous iron infusion reactions. *Hypotension is defined as a drop of 30  mmHg or more in systolic blood pressure from baseline or systolic blood pressure of equal to or less than 90  mmHg. **Methylprednisolone 125  mg plus or minus H2 antihistamine. We avoid first-generation H1 antihistamines (eg, diphenhydramine), as this can cause somnolence, tachycardia diaphoresis, and sometimes hypotension, mimicking an anaphylactic reaction. The majority of SAEs can be attributed to the use of diphenhydramine and/or epinephrine for the management of immediate infusion reactions. Adapted from Rampton et al.²⁰