Iron Infusion

Iron deficiency is common. Iron replacement therapy is sometimes recommended for people who are low in iron (iron deficient) or are low in iron with anaemia (iron deficiency anaemia or IDA). IDA is when there is a reduced level of haemoglobin due to iron deficiency. Your doctor will investigate the cause of your low iron and/or anaemia before recommending treatment options. In Australia current clinical management guidelines recommend the use of oral iron supplements as first-line therapy for most patients presenting with iron deficiency. Oral iron supplements sometimes can cause unwanted side effects (eg: nausea and constipation). There also may be situations when oral iron is ineffective or cannot be used. In these circumstances your doctor may recommend an iron infusion. If the body iron is particularly low, an iron infusion may be recommended to increase the iron stores quickly and/or to replenish body iron stores to remedy anaemia. Sometimes 2 iron infusions (given 1-week apart) are needed to top up iron stores. The infusion is made up of iron not blood.

FERINJECT® is an intravenous (IV) medicine that is used in the treatment of iron deficiency. FERINJECT® contains iron in the form of ferric carboxymaltose (FCM), an iron carbohydrate compound.

Iron is an essential element required for the oxygen-carrying capacity of haemoglobin in red blood cells and of myoglobin in muscle tissue. Iron also plays an important role in many other vital processes in the human body. Ferric carboxymaltose (FCM) is an iron preparation that allows larger single doses to be administered over a shorter infusion period compared with previously used IV iron preparations.

FERINJECT® is considered safe. In the past (older) iron infusions were associated with common side effects including allergic type reactions. This is much less common with FERINJECT®. However, as with all medications, FERINJECT® still has a potential risk for side effects. Your doctor will talk to you about the risks and the benefits of having FERINJECT® based on your medical history.

FERINJECT® is contraindicated if you:

• Are < 14 years old
• Are pregnant in the first trimester
• Have a known hypersensitivity to FERINJECT® or any of its components
• Have anaemia not due to iron deficiency
• Have haemochromatosis or iron overload
• Have uncontrolled low blood phosphate levels
• Have a severe infection or inflammation

It is rare to experience any significant side effects from an iron infusion with FERINJECT®. Some patients may experience a headache, dizziness, flushing or nausea. Less commonly some patients may experience a change in blood pressure and heart rate, a disturbance in taste, vomiting, constipation, diarrhoea, indigestion, stomach cramps, joint pains, itchiness, hives, skin irritation, fever and chills.

Very rare complications include anaphylaxis (which may be potentially fatal) and injection site reactions (permanent skin staining due to iron extravasation from IV drip displacement during the treatment).

Please refer to the full list of side effects of FERINJECT® contained in the Consumer Medicine Information (CMI) link. Ferinject®

For existing patients:

Your regular doctor at East Hills Medical Centre will advise what is required before your iron infusion.

Your doctor will provide you with a script for FERINJECT® to purchase from your local pharmacy before your scheduled infusion. You will be required to bring FERINJECT® to your infusion appointment. We recommend that you order your script for FERINJECT® from your local pharmacy at least 48 hours prior to your scheduled infusion appointment. No special storage at home is required for FERINJECT®. Do not store above 30°C. Do not freeze or refrigerate. Bring FERINJECT® to your appointment in its original package.

Remember to bring your FERINJECT® medication to your appointment. There is no special preparation needed for the iron infusion. However on the day of your iron infusion it is recommended you take an over-the-counter oral anti-histamine tablet (eg: Telfast, Claratyne or Zyrtec) as well a 1-gram of oral Paracetamol (eg: Panadol 500mg x2 tablets) 1-hour prior to your scheduled infusion appointment. No fasting from food or fluid is required. Please drink plenty of fluids (water) prior to your infusion as this will assist with placement of your IV drip by our doctor. It is recommended that wear comfortable loose-fitting clothing including a shortsleeved shirt to allow our staff to access your arm for IV drip placement and vital sign observation monitoring. You will be able to drive home after your iron infusion.

Please allow a total of 1-hour for this procedure. Your doctor will review you and complete consent before the procedure and then insert the IV drip into a vein in your arm. Our practice nurse will then administer the FERINJECT® infusion as prescribed by your doctor. The iron infusion generally takes 15-20 minutes to complete but you will be observed for a period of time after the infusion to monitor for potential side effects. Our practice nurse will monitor your infusion and vital signs (temperature, blood pressure, heart rate, respiration rate and pulse oximetry) throughout the entire procedure and observation period.

Your doctor will review you prior to discharge and advise what aftercare you require. If you have been referred to our medical centre for your iron infusion your regular GP or Specialist will be sent a discharge summary.

It is always important to monitor your own health after receiving an iron infusion. Minor reactions from FERINJECT® can occur up to 48 hours following your infusion. If you experience any significant side effects (eg: rash) it will be important for you to contact the doctor who administered the iron infusion at our medical centre immediately.

For all life threatening symptoms (eg: chest pain or difficulty breathing) you should call an ambulance via Emergency 000 (Triple Zero) or present to your local hospital emergency department as soon as possible.

We are bulk-billing medical centre however there will be an out of pocket cost for this procedure and this procedure will not be bulk-billed. If you are registered with Medicare you will be eligible for a Medicare rebate. The out of pocket cost to you is the payment difference between our fee and the Medicare rebate. You are also responsible for the cost of purchasing the script of FERINJECT® from your local pharmacy. If you are registered with Medicare the cost for FERINJECT® is the standard Pharmaceutical Benefits Scheme (PBS) script fee. 

We aim to provide the best quality medical care and this level of service will incur a gap or out of pocket payment. This payment is the difference between our fee and the Medicare rebate.