Intravenous iron can replenish iron stores when IV replacement is clinically preferable to oral treatment—for example when oral iron is ineffective, not tolerated, unsuitable, or when a more rapid replacement strategy is required. The appropriate product, dose and schedule depend on the patient and the indication.
Before intravenous iron
- The diagnosis of iron deficiency and the indication for IV treatment should be established.
- Relevant results may include full blood count, ferritin and transferrin saturation, depending on the clinical situation.
- The clinician may need to consider why iron deficiency developed—for example bleeding, menstrual loss, gastrointestinal disease, diet, pregnancy or impaired absorption.
- Tell us about previous reactions to IV iron, significant allergies, asthma, inflammatory/immune conditions, pregnancy and current infection.
What happens during treatment?
A peripheral IV cannula is inserted and the prescribed iron preparation is administered at the product-specific dose and rate. The patient is observed during treatment for symptoms suggesting intolerance or hypersensitivity.
Safety monitoring
European Medicines Agency safety recommendations state that IV iron should be given where staff and resuscitation facilities are available to manage anaphylactic reactions and that patients should be observed for signs of hypersensitivity during administration and for at least 30 minutes afterwards.
Possible side effects
Effects vary by iron preparation. They can include temporary taste disturbance, headache, nausea, flushing, dizziness, blood-pressure changes, muscle/joint symptoms or infusion-site reactions. Serious hypersensitivity is uncommon but potentially severe.
Follow-up
Clinical response and repeat blood tests are planned according to the severity of deficiency, the iron product and the reason for treatment. Iron deficiency can recur if the underlying source of iron loss has not been corrected.