Side effects of an iron infusion
Iron infusions can be a game changer when it comes to dealing with iron deficiency anaemia. But we always have to weigh the benefits against the risks. Most people tolerate iron infusions really well, but there are certain conditions and situations where we have to be careful and there are common and uncommon but serious side effects that should be understood as part of the calculation.
Ferrinject (ferric carboxymaltose) is what I use in my clinic. However, it's not without its share of side effects, and these should always be weighed up against the benefits. Here are some rules and guides to using Ferrinject iron infusions according to NPS MedicineWise
We usually decide on any medication by assessing the risks against the benefits. The benefits of Iron infusions I have discussed before, but now to talk about some of the particular risks.
Side effects
A few common adverse effects to keep in mind include nausea, injection/infusion site reactions, hypophosphataemia, headache, flushing, dizziness and hypertension.
Anaphylactic reaction, though rare, is a serious adverse reaction to be wary of and why we do it in a clinic and keep watching you for a while after the infusion.
Particular risks and caution areas
We will break this down from no-go, high risk, to with caution, use when benefits outweigh risks). Then we will touch on the side effects.
Where an infusion is a No-Go
Taking the Ferrinject route comes with possible risks, like any medication, and it's not a one-size-fits-all remedy. Here are some scenarios where Ferrinject may not be your best choice:
Allergic Reactions: Allergic reactions are the big one, and why we do it in a clinic where we can monitor for any immediate problems. If you have had any allergic responses to ferric carboxymaltose complex, Ferrinject itself, or any of its components, Ferrinject is a no-go.
Non-Iron Deficiency Anaemia: For anaemia not caused by iron deficiency like other microcytic anaemia, Ferrinject isn’t the solution.
Iron Overload: If there's evidence of iron overload or issues with iron utilisation, steer clear of Ferrinject.
With Caution
A few heads-ups and precaution situations when it comes to using Ferrinject
Iron Overload: The human body has a cap on iron excretion, and crossing this limit can lead to haemosiderosis. Regular monitoring is a must for those on Ferrinject to keep a tab on red cell indices and serum ferritin levels if for some reason you are getting regular infusions.
Infections, allergies, eczema: Exercise caution with Ferrinject if dealing with infections, asthma, eczema or atopic allergies. It's recommended to halt Ferrinject administration amidst ongoing bacterial infections.
Hypophosphataemia and Osteomalacia: There have been cases where IV iron led to hypophosphataemia, some requiring medical attention, especially in patients with risk factors and prolonged exposure to high-dose IV iron.
Leakage: Mind the administration to prevent injection site leakage as it may cause long-lasting brown discolouration and irritation at the site.
Sodium Content: Ferrinject carries a sodium content, something to consider for those on sodium-restricted diets. (only 0.3% of Recommended daily intake though).
Liver Dysfunction: For those with liver issues, a careful risk/benefit assessment is crucial before going the Ferrinject way.
Use in the Elderly and Paediatric Population: The data is scarce when it comes to Ferrinject’s effects on these demographics. Its use is not recommended for children below 1 year of age.
Drug Interactions with Other Medicine
Just a quick note: if you're on oral iron therapy or planning to start, it's advisable to pause it for at least five days after your Ferrinject administration.
Pregnancy, breastfeeding and fertility
While studies in animals have shown some adverse effects at maternally toxic doses, the data on humans is limited. During pregnancy, especially before 16 weeks, Ferrinject should only be used when clearly necessary and under careful evaluation.
On the Road
The impact of Ferrinject on one's ability to drive or operate machinery hasn’t been assessed, so that remains a grey area.
In a nutshell, while Ferrinject is a great tool against iron deficiency anaemia, it does come with its set of caveats. It's not a decision to be taken lightly and requires a thorough evaluation alongside a doctor's professional advice.
It's essential to consult with healthcare professionals before going for Ferrinject iron infusions, especially if you have pre-existing conditions or are on other medications. Iron infusions are a potent tool against iron deficiency, but like all medical interventions, they come with their set of considerations.
The information provided on this blog is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. While the author(s) of this blog are healthcare professionals, the content on these pages should not be taken as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call emergency services immediately.
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