Administration of intravenous iron

What does it mean?
Ιntravenous iron administration means direct administration to the body's circulatory system. Α needle placed in a peripheral vein is connected by a drop of iron-containing infusion which is mixed with a sterile saline solution.

What is iron and why is it necessary?
Iron is essential to the body to produce hemoglobin, a substance that carries oxygen from the lungs to the organs of the body. When the amount of iron in the body is low, the level of hemoglobin decreases below normal. This is known as iron deficiency anaemia and has the effect of feeling easy fatigue, paleness, dyspnoea during exercise, palpitation and angina especially in vulnerable groups and the elderly.

Why do I need intravenous iron administration?
The most common way to treat iron deficiency anemia is to take iron as a pill or syrup. This brings good results for most people and is usually recommended as first treatment. Intravenous iron may be needed if:
You can’t tolerate the oral iron intake.
The intestine cannot absorb the iron.
You cannot absorb enough iron due to blood loss.
You need a rapid increase in iron levels to avoid significant complications or blood transfusion (before or after a surgery, severe anaemia in pregnancy or childbirth).
You do not respond to iron pills (due to chronic health problems).
Chronic kidney or heart failure.

Alternative options:
Iron pill: Iron pill is the first choice you should try (unless you need a faster increase in hemoglobin). If you have stomach irritation with iron pills, you can try a lower dose of iron in syrup. Usually pills that claim to be mild for the stomach, do not have a decent amount of iron to cope with anaemia.
Blood transfusion: Blood transfusion can be a life saver if there is a severe anaemia or bleeding. However, it carries greater risks than intravenous iron and should be avoided unless a direct increase in hemoglobin levels is required.
Nutrition: A person already anaemic, is difficult to obtain enough iron with a high iron diet.

Important questions:
Please answer the following questions carefully to assess potential risk factors:

1.    Did you have any allergic reactions while taking iron                              
in any form in the past?                                     
2.    Do you have a history of asthma, eczema or other allergies?                  
3.    Do you take any other medication over the counter or                          
botanical complexes?                                           
4.    Do you have a medical history of high iron levels, hemochromatosis    
or any liver problems?                                 
5.    Any possibility of being pregnant or planning soon?                       

The amount of iron required:
Your doctor will calculate how much iron is needed to raise hemoglobin levels to normal. It will take a few weeks until the iron treatment will have its full effect and your doctor will test your hemoglobin to see the response to treatment.

Types of intravenous iron:
Ferrous gluconate (Venofer): It is preferable not to be administered once at a high dose but to be administered in a series of small doses that last about half an hour and are repeated over days or weeks.
Iron carboxymaltose (Ferinject): is administered in a medium dose over fifteen minutes. It might be needed to repeat the treatment once more in the future.
Possible side effects during administration of intravenous iron:
With the new generation intravenous iron formulations, undesirable effects have been minimized and mainly occur during the administration or about half an hour later. The most significant risk of intravenous iron is the small chance of an allergic reaction, which may, in rare cases, be life threatening. 

Other possible reactions: temporary changes in taste (for example metallic taste), headache, nausea or vomiting, muscle and joints pain, short of breath, itchiness, skin rash, changes in blood pressure measurements or pulse, heartburn feeling and swelling at the intravenous injection side. 
Nursing staff will carefully monitor for any side effects. In some rare situations, side effects such us, headaches, muscle or joints pain, can be noticed one or two days after the intravenous administration of iron treatment. It is expected for these side effects to resolve within the next days, but if it concerns you, don’t hesitate to contact your doctor for advice.
The day when the intravenous iron administration will take place, you can have breakfast /lunch and take your regular medication if any. You will be able to drive back home at the end of the treatment and continue with your everyday activities.