Intravenous iron therapy

What is intravenous (IV) iron therapy?

Intravenous (IV) iron is an infusion of iron directly into your bloodstream. We use it to treat iron deficiency and anaemia. It is an alternative to iron tablets or liquid. We may offer it if iron tablets or liquid has not worked for you or they have given you side effects. You may be offered IV iron therapy to quickly improve your iron levels.

Why iron is important

Iron is an important part of haemoglobin (Hb). This is the red pigment which gives blood its colour and which carries oxygen around your body. A lack of iron (iron deficiency) is the main cause of anaemia (low Hb).

If left untreated, iron deficiency can lead to anaemia. Anaemia can make you feel very tired. You can become short of breath and your heart can beat very fast. You may feel it beating in your chest (palpitations).

Untreated anaemia can increase the chance of needing a blood transfusion should you become unwell.

How IV iron therapy works

Intravenous (IV) iron therapy is when iron is directly infused into your bloodstream. We often use Ferrinject©, which is a type of IV iron therapy. It is usually given when your blood tests show that your Hb and ferritin (iron stores) are low.

A small tube (cannula) is inserted into a vein in your arm. The liquid iron is a dark brown coloured solution which is then given as an infusion (a drip). The liquid IV iron is given through a pump and takes approximately 15 minutes to infuse.

You will be asked to wait for 30 minutes after the procedure to make sure you feel well enough to leave.

Benefits of IV iron therapy

Your blood iron levels will increase. This may result in your haemoglobin increasing as well.

You may notice you:

feel less tired
have more energy
can concentrate better
are less breathless when exercising

Risks and side effects

All drugs have risks of unwanted side effects. IV iron is typically very safe. Potential side effects can occur. The side effects are temporary and will typically resolve within 3 days. It may take longer for your phosphate levels to return to normal.

On rare occasions, fluid can leak out of the cannula during the infusion. This can cause long term or even permanent staining of the skin.

Inform the nurse immediately if you feel unwell or have any pain around your cannula during the infusion.

Common side effects

Common side effects can include:

headaches
dizziness
raising or lowering your blood pressure
nausea
low phosphate levels (hypophosphatemia)

Rare side effects

Rare (affecting less than 1% of patients) side effects include:

vomiting
fainting
tingling or numbness of arms and legs
stomach (abdominal) discomfort
constipation or diarrhoea
shortness of breath
muscular and joint aches
fever
rashes and skin flushing
swelling of hands and feet
a significant allergic reaction called an anaphylactic reaction

You should not receive IV iron therapy if you:

are sensitive (allergic) to any iron preparations intended for intramuscular or intravenous administration
have damage to your liver
have any acute or chronic infections
are within the first 12 weeks of pregnancy
have iron overload

Where you will be treated

We will contact you to organise the treatment. This will be with the nursing team in a clinical environment. You will be closely monitored during the infusion and for a short time after the infusion.

The dose of Ferinject© will depend on your haemoglobin level and body weight. Some people may need to have the dose split over 2 infusions, a week apart.

After the IV iron therapy

If you are well enough to go home, you will be discharged. You should be well enough to drive home, use public transport or travel home alone.

Your body will need time to use the iron and make new red blood cells. Your Hb levels should increase within 4 to 8 weeks. You may be asked to get a repeat blood test around this time to see how you have responded to the iron. You may require further monitoring of your Hb and ferritin levels in the future.

What to do if you feel unwell

If you feel unwell after your treatment contact your local GP or 111. Tell them that you have had an intravenous iron infusion.

They will advise whether you require further medication or should attend an emergency department.

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