Iron Infusion- Intravenous Iron

Ferinject (ferric carboxymaltose) is special type of liquid iron given through a cannula into a vein (also known as an ‘infusion’). Ferinject is sometimes used instead of iron tablets or if the oral tablets have not had the desired effect during your pregnancy or after your baby has been born. Ferinject is usually given over two infusion one week apart to help improve your iron levels.  

This will be given in our Day Assessment Unit; your midwife will put a cannula (small tube in your vein) and give a flush of fluid down this. They will then start the Ferinject infusion which usually takes around 15 minutes. You will need to remain for around 30 minutes post your infusion to ensure you feel well and then return for your 2nd infusion. You will be given a booked time to arrive at the unit however based on DAU activity we ask that you allow around 1-2 hours for this appointment.    

If you have low iron that remains untreated then it can lead to several of these side effects:  

• shortness of breath  ● Irritability  

• feeling tired/ Lack of energy ● Poor concentration 

• dizziness  

The reasons we would offer this infusion is:  

• Blood tests show you are anaemic and oral iron tablets have not improved your iron levels or have made you feel unwell. Iron deficiency anaemia can occur when your body is not getting enough iron and cannot produce enough red blood cells. It is common for women who are pregnant or who have just given birth to have iron deficiency anaemia.

• You had a significant blood loss after the birth of your baby (causing your iron levels to be low), but otherwise you are feeling well.

• You have decided not to have a blood transfusionandFerinject may be offered to you as an alternative to a blood transfusion. Although blood transfusions are safe, there are some risks associated with them, including a small risk of infection. Ferinject is not a blood product, so it does not have the associated risks of a blood transfusion. Your midwife or obstetrician will discuss your options with you. 

Possible Side effects:  

Ferinject is considered safe to use after the first 3 months of pregnancy and very rarely causes allergic reactions. Throughout your infusion you will be monitored by a member of staff and will be asked to report any concerns you have throughout the duration of this.  

A rare but significant possible complication is permanent skin staining or discolouring around the cannula site or possibly extending further up the arm. This occurs if there is leakage of the iron outside your vein. We reduce the risk of this occurring by ensuring the flush of fluid before the infusion begins goes in smoothly.  

Other possible side effects include:  

• Headache  ● Dizziness 

• Nausea and vomiting  ● Rash  

• Diarrhoea  ● Constipation 

• Abnormal Liver function  ● Flushing  

• Abdominal pain             ● Muscle cramps  

• Low or high blood pressure ● Injection site reactions 

Are there any alternatives to intravenous iron?  

As you are requiring intravenous iron it is likely that your doctor has decided oral iron tablets are not effective or you may not be able to tolerate them. If you decide that you do not wish to have intravenous iron you may require a blood transfusion to correct your anaemia when your baby is born. Blood transfusions are associated with some short- and long-term side effects/ risks. Please discuss this with your doctor or midwife if you do not wish to have the infusion.  

What happens next?  

Your full blood count (blood test) will be offered after 14 days to ensure that the treatment has had the desired effect on your iron levels. We can prescribe up to 3 infusions following discussions with the obstetric team.  

If you are taking Iron tablets orally then please stop these for 5 days following your infusion and the midwives on the Day assessment unit will follow up your blood result. They will contact you via the telephone to discuss further actions if any are required.  

Note. This document uses the term women throughout, but this term should be taken to also include people who do not  identify as women but who are pregnant, in labour and in the postnatal period.  

Our Maternity Information Leaflets for parents and service users are reviewed regularly by parents and service users. If you have any comments/feedback about this leaflet or are interested in looking at future leaflets, please contact our Maternity & Neonatal Voices Partnership (MNVP)  www.bswmaternityvoices.org.uk  

Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ 

www.salisbury.nhs.uk/wards-departments/departments/Maternity