Intravenous Iron Supplementation Therapy

Recently intravenous iron infusion has evolved to be a safe cornerstone in the treatment of iron deficiency.

Newer intravenous iron formulation (MonoFer) is known to have an improved safety profile, better tolerability, effectiveness and efficacy compared to oral iron supplementation.

Oral iron is often poorly tolerated, with up to 70% or more of patients experiencing gastrointestinal issues and this may affect adherence to therapy. In addition, many patients will not respond to oral iron due to their underlying illness. Intravenous iron is being used more frequently to replete iron stores

One of the most common indications for iron supplementation is Iron Deficiency Anaemia (IDA).

WHO facts about IDA:

  • 2 billion people are anaemic worldwide largely caused by iron deficiency


How does IDA affect an individual?

  • Physical capacity and work performance in adolescents and adults
  • Immune status and morbidity from infections in all age groups
  • Cognitive performance, behaviour and physical growth in children
  • Rapid and irregular heart beat leading to enlarged heart or heart failure
  • Increases perinatal risks for mothers and neonates
  • Increases risk for negative pregnancy outcomes

Signs and Symptoms of IDA:

  • Brittle nails
  • Hair loss and poor hair quality
  • Cold intolerance
  • Depression
  • Easy bruising
  • Reduced exercise capacity
  • Lethargy
  • Dizziness
  • Poor concentration/ Brain fog

Treatment options for IDA:

  • Oral Iron: First line treatment
  • IV Iron infusion
  • Blood transfusion

What is Iron Infusion and what are its benefits?

Iron infusion is mainly indicated for those who are unable to tolerate oral iron or if someone needs rapid iron correction.

Benefits:

  • IV Iron has 100% bioavailability
  • Serious side effects are rare
  • Effectively improves anaemia and reduces risk for blood transfusion requirement

MonoFer is the most recent IV iron registered in Malaysia. The iron content per vial is 500mg & 1000mg. MonoFer is known to correct IDA in just ONE visit by allowing controlled release of iron to the body.
It has a good safety profile, convenient and cost-effective.

Diagnosis of Iron deficiency:

Serum ferritin is the recommended lab test for evaluation of iron stores. Normal serum ferritin values are 100-300 ng/ml.

Serum ferritin <30ng/ml is the most sensitive (92%) and specific (98%) cut-off level for identification of absolute iron deficiency with or without anaemia.

How do we administer intravenous iron?

  • Iron infusion is done with a maximum dilution of 500ml over 15-30minutes depending on the dosage.
  • The procedure is usually done in the doctor’s clinic and it may take about 1-2hours depending on the dosage prescribed.

Estimation of Iron requirement

  • 500mg of iron 2-3g/Dl Hb increase
    (Initial increment within 1-2weeks and normal levels achieved by most anaemic patients within 1-2months)

  • 8mg of iron reflects 1ng/mL of serum ferritin
    (Improved wellbeing within a few days of iron treatment)
    Retesting of serum ferritin after 4 weeks.

How quickly will the treatment work?

Most patient`s generally feel their energy level improve within a couple of weeks. However, this can vary depending on the individual.

Iron infusions are an effective way to treat IDA. This will be a perfect choice for those who cannot tolerate oral iron. You can discuss this with your doctor for further information to correct Iron deficiency in a fast but safe method.

Common FAQs for iron infusion service:

1. How much is it?

Starting from RM1300


2. How long does it take?

Approximately one hour


3. Can there be too much iron in the body?

Simply put, yes. This is a condition known as haemochromatosis. We will take blood samples from you before an infusion to determine your iron levels.


4. How is this done?

We will set an intravenous needle into your arm or hand and allow the iron (in liquid form) to slowly flow into the body via your veins.


5. Is this better than oral medication?

There are different indications for a person to start oral medication versus infusion treatments like this. If you are indeed suitable and require a large amount of iron to be corrected in the body, an infusion is definitely the way to go.

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