Intravenous iron – Safe administration


Iron deficiency is common in Australia, but one of the most underdiagnosed conditions in primary care. The clinical consequences of iron deficiency can be significant and include impaired immune function, adverse pregnancy outcomes, and cognitive and intellectual impairment in children. Treatment choices are influenced by the severity of the deficiency and the presence of comorbidities. Iron supplementation is always required in cases of frank iron deficiency anaemia (IDA).

Oral iron therapy is an effective first-line strategy for most patients with iron deficiency anaemia. However, parenteral iron is used when oral therapy has failed or is contraindicated, or when rapid iron replacement is required. Intramuscular (IM) iron should be avoided as it is painful, usually requires multiple treatments, and is no safer than intravenous (IV) iron. Current non-dextran formulations of IV iron have good safety profiles, and serious adverse reactions are very rare.

Ferric carboxymaltose is the recommended IV iron formulation for use in primary care settings (with resuscitation facilities on hand), as it can deliver large doses of iron quickly (for example, 1000mg in 15 minutes). This module covers the rationale for, and practice of giving, IV ferric carboxymaltose for iron deficiency anaemia. It is aimed at primary care practitioners.

This module is one of three modules related to iron deficiency. They are linked and it is recommended that participants undertake all three modules: Iron deficiency anaemia in adults, Iron deficiency anaemia in children and Intravenous iron – Safe administration

Learning Objectives

At the end of this module participants will be able to:

  • Understand the importance of correcting iron deficiency.
  • Explain the principles of intravenous iron therapy.
  • Identify patients suitable for intravenous iron therapy.
  • Determine the appropriate dose of ferric carboxymaltose for specific patients.
  • Recognise adverse events following intravenous iron administration.

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