Everything you need to know about Iron Infusions.

Why is iron important?

Our bodies need iron. Iron is used to make haemoglobin – the part of our red blood cells that carries oxygen around our body. It is also important for muscle strength, energy and good mental function. If your iron levels are low this may make you feel tired and not able to do normal daily activities. As the amount of iron in the body falls even lower, the haemoglobin levels drop below normal. This is known as iron deficiency anaemia.

Why might I need IV Iron?

The most common way to treat iron deficiency is to take iron by mouth as a tablet or liquid. This works well for most people and is usually tried first. Some people may need iron to be given straight into the body through a vein. This is called and Intravenous (IV) iron infusion. The iron is given through a needle and dripped (‘infused’) into your vein. Sometimes 2 iron infusions (given at least 1 week apart) are needed to fully top up iron stores. The infusion is made up of iron, not blood. IV iron might be needed if you:

• Are not able to take iron tablets / liquid

• Are not responding to iron tablets / liquid or not absorbing them

• Need to get your iron levels up quickly e.g. Before major surgery, late in pregnancy or to avoid blood transfusion

• If you have chronic kidney disease or chronic heart failure

What is Ferinject?

Ferinject is an intravenous iron preparation, a medicine that is used in the treatment of iron deficiency conditions, when oral iron preparations are ineffective or cannot be used. It contains iron in the form of ferric carboxymaltose, an iron carbohydrate compound.

Before you have an Iron infusion:

Prior to your infusion you will require a consultation with a doctor to assess the potential causes of your iron deficiency. You may be required to have further blood tests following your consultation.

If your regular GP or Naturopath is referring you for an iron infusion you do not require a consultation with a doctor at Riverview Medical Practice. It is important that you attend with a detailed referral from your GP outlining the reason for your iron deficiency and your relevant past medical history, including any recent blood tests.

You will be provided with a prescription for your iron infusion – this can also be obtained from your referring GP. This prescription can be filled at any pharmacy and will cost around $30 to $40. Bring this to your infusion appointment.

What to tell your doctor:

You need to tell your doctor and this medical practice if you;

• Are pregnant / trying to get pregnant. IV iron should be avoided in the first trimester

• Have a history of asthma, eczema or other allergies

• Have had a reaction to any type of iron injection or infusion in the past

• Have a history of high iron levels, haemochromatosis or liver problems

• Are on any medications (including herbal and over the counter medicines)

• Have (or may have) an infection at the moment.

What happens during your appointment?

Infusion therapy involves the administration of a medication through a needle or cannula. The cannula is usually inserted into a vein in your hand or arm and is then connected to a sterile bag that contains the fluid or medication to be infused. During your infusion our nurses will measure and record your vital signs, such as blood pressure, heart rate and oxygen saturation.

What to bring/What should I wear?

It is recommended that you wear comfortable loose-fitting clothes. Your sleeve will need to be pushed well above the elbow. This will allow our nurses to more easily insert the cannula and to monitor your vital signs. As some IV fluids may make you feel cool, it is also suggested that you bring a jacket or cover to keep warm. We encourage you to relax whilst you are having your infusion, please bring reading material or something to occupy your time.

Procedure Preparation

It is important that you are well hydrated prior to your procedure. If you are able, please drink water before your treatment. If you suffer from a heart or kidney condition, please discuss the appropriate amount of hydration with your doctor.

How long will the infusion take?

Most infusions take less than 30 minutes and you will be monitored by our nurses during the infusion. You will then be observed for 30 minutes post infusion, and assessed by your Doctor before being discharged.

Are there any side effects with IV iron?

Generally, when side effects do occur, they are mild and settle down on their own. The most common side effects (occurring in 1-10% of cases) are temporary and include:

•  Headache, feeling sick or vomiting, muscle or joint pain, dizziness

• Changes in taste (e.g. metallic)

• Changes to blood pressure or pulse

• Injection site reactions

Skin staining (brown discolouration) may occur due to leakage of iron into the tissues around the needle (drip) site. This is not common, but the stain can be long lasting or permanent. Inform the doctor or nurse straight away of any discomfort, burning, redness or swelling at the needle (drip) site.

Although very uncommon, some people may have a serious allergic reaction (anaphylaxis). In rare cases this can be life threatening. You will be closely monitored while IV iron is given, and for 30 minutes after.

Sometimes side effects (e.g. headache, muscle or joint pain) can start 1 to 2 days later. Mostly they will settle down by themselves over the next couple of days. If they worry you or interfere with your daily activities seek medical attention.

If you have chest pain, trouble breathing, dizziness or neck / mouth swelling, please seek urgent medical attention / call an ambulance (000).

How much does an iron infusion cost?

In addition to the cost of your prescription, there is an out of pocket expense to cover treatment room costs, and is not claimable from your private health fund or Medicare. The Doctors fee for this service will be bulk billed directly to Medicare.

After your Iron infusion:

You will be required to have further blood tests approximately 4 weeks after your infusion.  This is to ensure your iron levels are within ‘normal limits’. It is pertinent that you have additional blood tests approximately 3 months after your blood tests to ensure iron levels remain within ‘normal’ limits.