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Evolution of IV Iron Infusions

Intravenous (IV) iron infusions have significantly transformed their role and safety in treating low iron levels.

Modern Iron Formulations

Today’s IV iron treatments utilize advanced formulations composed of tiny particles containing iron. These formulations include iron dextran, iron isomaltose (formerly known as iron isomaltose 1000), ferric carboxymaltose, ferumoxytol, iron sucrose, and sodium ferric gluconate. Depending on the specific formulation used, they offer the convenience of correcting low iron levels with just one or a few doses over 1-2 weeks.

Managing Risks

While IV iron treatments are generally safe, there remains a small risk of severe reactions during infusion, affecting less than 1% of patients. Consequently, doctors typically reserve IV iron for individuals with iron deficiency anemia who cannot tolerate or respond adequately to oral iron supplements. This article discusses the costs of iron infusions.

Identifying Underlying Issues

Iron levels may appear normal despite an underlying deficiency in cases of inflammation. This highlights the importance of monitoring additional indicators like transferrin saturation to ensure accurate diagnosis and treatment.

Improving Quality of Life

The primary aim of IV iron therapy is to enhance the quality of life for individuals with low iron levels. Doctors often assess treatment efficacy through parameters such as hemoglobin levels.

Emerging Concerns

Despite its benefits, one particular IV iron treatment, ferric carboxymaltose, has been associated with a new complication—low phosphate levels. This can lead to adverse effects like bone pain and fractures, underscoring the importance of vigilant monitoring.

Tailored Treatment Approach

To ensure the safety and effectiveness of IV iron infusions, it is essential for healthcare providers to carefully select the appropriate treatment for each patient and closely monitor their response throughout the treatment process.


In summary, IV iron infusions represent a pivotal intervention for individuals unable to tolerate oral iron supplements. While generally safe, close attention to patient response and potential complications is crucial for optimizing treatment outcomes and ensuring patient well-being.

Please see your GP to discuss iron infusions.


Avni T, Bieber A, Grossman A, Green H, Leibovici L, Gafter-Gvili A. The safety of intravenous iron preparations: systematic review and meta-analysis. Mayo Clin Proc. 2015 Jan;90(1):12-23. doi: 10.1016/j.mayocp.2014.10.007. Epub 2014 Oct 30. PMID: 25572192.

Schaefer B, Meindl E, Wagner S, Tilg H, Zoller H. Intravenous iron supplementation therapy. Mol Aspects Med. 2020 Oct;75:100862. doi: 10.1016/j.mam.2020.100862. Epub 2020 May 19. PMID: 32444112.

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