Montserrat Gastroenterology and Digestive Health Experts

A small cannula is inserted into your arm and iron is infused over 15 minutes (or longer depending on the iron used) into your vein.

Who can receive Intravenous Iron Supplementation?

Patients who receive intravenous iron commonly do so because they cannot take iron orally, due to:

• Side effects of oral iron being intolerable
• A trial of oral iron has not increased the patient’s iron levels
• Oral iron is not absorbed due to gastrointestinal disease (coeliac disease)
• Oral iron cannot replace enough iron due to ongoing bleeding/blood losses (eg. heavy periods, gut bleeding)

Other patients who receive intravenous iron infusions are:

• Patients who are anaemic and need to increase their blood levels quickly (without resorting to a blood transfusion)
• Patients who are bleeding in the gastrointestinal tract and need to replace iron quickly
• Patients who have Inflammatory Bowel Disease (IBD) and cannot take oral iron because it upsets their gastrointestinal tract
• Patients who are on kidney dialysis
• Patients with iron-deficiency anemia who are having high blood loss surgery within the next two months
• Patients with coeliac disease
• Cancer patients who have anemia and are taking Erythropoiesis Stimulating Agents (ESAs)

• Eat your breakfast and lunch as there is no need to fast for an iron infusion
• Take your regular medications
• Be prepared to have a small IV drip put into your arm or hand
• Know how to call for help during your infusion in case you have a reaction

Intravenous iron is a common and safe procedure and is usually well tolerated, however, like all medical procedures there are known side effects. These side effects are usually minimal, but they may include:

1. Iron Staining at Site of Infusion (Tattooing)
   This is a rare side effect, which is easily avoided. When the cannula is inserted into the vein, in preparation for the iron infusion, if the cannula is misplaced, the iron will be deposited under the skin, leading to a permanent tattoo. To prevent tattooing, when our Gastroenterologist inserts the cannula, it is flushed afterwards with saline to ensure it is in the correct position and it is monitored carefully during the infusion.
2. Allergic Reactions
   With the newer intravenous iron formulations, severe allergic reactions (anaphylaxis) are rare. Occasionally some patients will develop hives after the procedure, which usually respond to antihistamines. If you have severe allergies, sometimes an antihistamine will be given before the infusion.
3. Post Infusion Reaction
   This occurs up to one week later in approximately 5% (or 1 in 20) patients. It is not an allergic reaction, but rather a reaction of the body to the iron. Flu-like symptoms can occur, including:
   – Fever
   – Headache
   – Muscle aches and pains
   – Gastrointestinal discomfort
   – Nausea
   – Vomiting or
   – Diarrhoea

   Reactions like this are usually self-limited to 24 hours and will resolve on their own

   Other possible reactions, which happen rarely include:

   – Bloating or swelling of the face, arms, hands, lower legs or feet
   – Dizziness or light-headedness when getting up suddenly from a sitting or lying position
   – Problems with breathing
   – Chest pain
   – Low blood pressure

4. Delayed reactions
   Rarely (after iron infusions) have there been reported cases of prolonged hypophosphataemia (low Phospate levels) requiring prolonged replacement. This is more likely to happen if your Vitamin D levels are low (but are still extremely rare).