Iron infusions

Who should get IV iron?

Health Canada has approved iron to be given in the vein (IV) for people who have iron deficiency anemia and also have kidney disease. However, IV iron has been studied for many conditions “off label.” Your doctor may suggest IV iron for iron deficiency anemia if you have side effects to iron pills, if iron pills have not worked, if you have severe anemia, or if you are going for surgery very soon.

Iron deficiency anemia means:

  • Low red blood cells – hemoglobin level less than 120 g/L (grams per litre).

  • Low iron level – ferritin under 30 μg/L (micrograms per litre), or under 200 μg/L with iron saturation less than 20%.

To ensure you are a good candidate for an iron infusion we require an initial IV screening assessment with our Nurse Practitioner (cost $60) to review recent lab work and health history.



What are the risks of intravenous iron?

Common side effects (about 1 person in every 20 may have these):

  • low blood pressure (dizziness)

  • muscle cramps

  • joint pain

  • headache

  • injection site swelling

  • chest discomfort

  • nausea, vomiting and/or diarrhea

Serious allergic reactions (rashes, face swelling and wheezing) including anaphylaxis, are rare.

After you get IV iron, you will be watched for 30 minutes to make sure you do not have an allergic reaction or a drop in your blood pressure.

If you have any serious reactions after leaving the clinic, go to your closest emergency department immediately, or call 911.

Before your first dose of IV iron tell your doctor or nurse if you are allergic to any medications, including iron pills.

Which forms of IV iron might I get?

Two products are supplied by most pharmacies:

  • iron sucrose (Venofer®)

  • iron isomaltoside (Monoferric®)

You and the nurse practitioner will talk about which one is right for you.

You may need one or more doses which are given about one to two weeks apart. This will depend on how severe your anemia is and which IV iron product your doctor ordered.

  • Venofer® is given in the vein over a two-hour infusion.

  • Monoferric® is given in the vein over a 30 to 60 minute infusion.

You do not need to take your oral iron pills on the day you get the IV iron.

Do I need to pay for my IV iron and how much does it cost?

  • You will have to pay for your IV iron. The cost of Venofer® is approximately $145 for a dose of 300 mg and Monoferric® is $274 for a dose of 500mg. Payment is made to the pharmacy for the prescription iron. If you have private insurance, Venofer® or Monoferric® may be on the list of covered medications.

  • The cost of the infusion by the nurse practitioner in clinic is $175.

How do I get my supply of IV iron?

  • The Nurse Practitioner will provide a prescription for iron.

  • Your IV iron prescription can be filled at any pharmacy location.

  • You will then bring your unopened/sterile iron to the clinic on the day of your infusion for the nurse practitioner to prepare.

 

Why is iron important?

  • Iron is an essential mineral. It is part of hemoglobin. Hemoglobin carries oxygen in the blood and helps make red blood cells. If you have very little iron, you may have very few red blood cells. This condition is called anemia.

Why does oral iron (in pill form) not work as well as intravenous iron (in the vein)?

  • Some people may have side effects from oral iron pills, or cannot absorb oral iron into their body. It can also take many months for you to get the same dose of iron from oral iron as you can get from one dose of intravenous (IV) iron (iron given in the vein).