A Patient’s Guide to Intravenous Iron

Your blood tests have shown that you have a type of iron-deficient anaemia. You will be prescribed an iron intravenous infusion (given by a drip into the vein) to correct the iron levels in your body before surgery.

You may be offered intravenous iron if:

• Iron tablets have not worked or because of side effects they may have caused.

• You have a certain type of iron deficiency that doesn’t respond well to iron tablets.

• We need to improve your iron levels quickly before surgery.

Iron is important because it helps your body to make haemoglobin. Haemoglobin, or ‘Hb’, is a protein found in red blood cells, which carries oxygen from your lungs to the rest of the body and gives blood its red colour.

If your iron levels are low, your red blood cells may not contain enough haemoglobin or their production may fall. This is called anaemia. At first, you may not notice any difference. However, as the amount of haemoglobin falls further, you may start to feel tired. Other symptoms include dizziness, shortness of breath, difficulty in concentrating, cold hands or a fast or irregular heartbeat.

Patients with anaemia, who are going for surgery, are likely to have an increased risk of complications and the need for blood transfusions during and after the operation, compared to patients who don’t have anaemia. Because of this, we like to treat all patients with anaemia, where possible before they come to surgery, to help reduce this risk. This may mean deferring your surgery until we have had time to do this in order to achieve the necessary level of iron.

We will also inform your GP that you are receiving this treatment for anaemia and they may wish to investigate this further.

Before you receive an iron infusion:

• If you are unwell with an infection.
• You have problems with severe asthma, eczema or problems with allergies or inflammation.
• If you are taking any other medications or over-the-counter remedies or herbal medicines. This is because the iron infusion can affect the way some medicines work. Also, some other medicines can affect the way the infusion works.

If you are not sure if any of the above applies to you, talk to your doctor or nurse before having intravenous iron.

The iron infusion we use at our hospital is called Monofer®. You will need to attend the hospital’s IV Suite for up to 2 hours. You do not need to fast. You can drive yourself or come on public transport. You do not necessarily need someone to accompany you. When you arrive at the IV suite, you will sit in a comfortable chair. A nurse will put a drip into one of your veins. The infusion can take around 30 minutes to complete, the nurse will monitor your blood pressure during and for at least 30 minutes after the infusion is completed. You can use this time to relax or read.

Like all medicines, Monofer® can cause side effects, although not everybody gets them. These include:

• Rash, nausea and skin reactions at or near injection site including redness of the skin, swelling, burning, pain, bruising, discolouration or irritation.

• Very rarely, severe anaphylaxis allergic reactions may occur therefore you will be monitored closely during and after the infusion.

If you have been taking iron tablets please stop taking them as you will no longer require them after your iron infusion. If you have been advised to take oral iron, it should not be started earlier than five days after the infusion.

If you need to have follow-up blood-tests to check your response to the treatment, the nurse will arrange these, usually 6 weeks after your infusion. These can take place at your GP surgery or at the Pre-Admission unit in the Royal National Orthopaedic Hospital, Stanmore. If you have any further questions, please call 020 8909 5630 or email rnoh.pre-admissions@nhs.net