Have you ever administered IV iron?

  1. Here's one of those annoying questions, I guess. I've looked it up, but the procedure sounds very scary. Doc has to be the one to do the test dose, etc., etc., I've never given it. I've never heard of it given where I was working. None of my friends have ever given it or been in on giving it. I've learned the z-track IM method for if I ever have to give iron IM, but I never have done. Doc says that anaphylactic is almost as common with IM as IV.

    So - have any of you actually administered it, or witnessed it? Did the person who had the infusion survive the whole thing?

    I'm having problems with anemia. I don't want another transfusion, but it's almost sounding like that's safer than the IV iron??? (I'm just kidding - no way !! - 2-3 units of blood Q 3 months - Not with the blood shortage and the Hep situation). Although I do have a lot of O+ people who are willing to donate for me.

    Love

    Dennie
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  2. 21 Comments

  3. by   capgirl
    Are you talking about Ferrlecit? I have given it many times, never witnessed any untoward effects - granted it is given slowly, with monitoring.
    here is the link to the FDA site.
    http://www.fda.gov/cder/consumerinfo...nfo/ferrle.htm
  4. by   NurseGirlKaren
    Have done it, no problems. We've treated it carefully, premedicated, like w/ Amphotericin B. Just make sure it's run SLOWLY, heads off untoward effects.
  5. by   sunnygirl272
  6. by   ?burntout
    Originally posted by NurseDennie
    Here's one of those annoying questions, I guess. I've looked it up, but the procedure sounds very scary. Doc has to be the one to do the test dose, etc., etc., I've never given it. I've never heard of it given where I was working. None of my friends have ever given it or been in on giving it. I've learned the z-track IM method for if I ever have to give iron IM, but I never have done. Doc says that anaphylactic is almost as common with IM as IV.

    So - have any of you actually administered it, or witnessed it? Did the person who had the infusion survive the whole thing?

    I'm having problems with anemia. I don't want another transfusion, but it's almost sounding like that's safer than the IV iron??? (I'm just kidding - no way !! - 2-3 units of blood Q 3 months - Not with the blood shortage and the Hep situation). Although I do have a lot of O+ people who are willing to donate for me.

    Love

    Dennie
    I've given IV iron many times (although it has been awhile lately)...
    We give a test dose-25 mg-usually over 10 minutes and monitor the patient for an hour....after an hour and there is no reaction, we give the iron by IVPB....
    Usually if you are going to have a reaction-it will be during the test dose..........SO FAR, SO GOOD

    (((Dennie)))...hope you find something to help:kiss
  7. by   jemb
    We give it a lot where I work. We used to give Infed -with a test dose first, followed by the full dose. Never had any severe reactions. Now we usually give Venofer instead, because the chance of adverse reactions is much less. I've seen no bad reactions to it at all.

    Personally, I would not hesitate to take it if I needed it.
  8. by   altomga
    I have also give Iron IV many times. Like the other post though...it has been awhile. Our protocol is basically the same. We give a test dose and monitor the patient with the first infusion, then administer the rest of the infusion slowly over many hours. I have never seen any reaction to it myself and actually have not heard any of my co-workers mention any either. Sometimes we give a pre-med (like with Ampho) if the doc thinks there is a chance of reaction, but not always.
    Good luck with whatever you decide
  9. by   canadian
    We give iron in our tpn all the time....it just needs to be filtered below the lipid/trav y...special filters ours are blue....lipids and iron make nasty precipitates.....I guess we use lower doses in tpn so I've never seen any special precations for it.
  10. by   das
    I work in an outpatient Hem/Onc office and we give Iron Dextran, Ferrlecit, and Venofer and (thank goodness) have had no problems. ALWAYS ALWAYS do the test dose. Our Docs require 30 min wait after test dose and then the infusion (depending on the med) over 3-6 hours. Premedicate with Benadryl and tylenol.
  11. by   TELEpathicRN
    I work acute hemodialysis now, but transferred from chronic dialysis, where you give IV Iron out the whazoo!!!!! It isn't as bad as the books make it sound!! There have been alot of reactions with Infed. It is a drug (all irons) that should be taken very seriously. I have never seen anyone have any problem with Ferrlecit or Venofer. You can actually push Venofer over 5-10 mins, but most hospitals are opting to mix it in 50-100cc NS and infuse it over 1 hr or so. Just do whatever is safest, but don't be so scared of it!!
  12. by   renerian
    I have done it with no problems.

    renerian
  13. by   NurseDennie
    Wow - thanks, you guys. I knew there would be people on here who have given it and/or seen it given.

    Thanks for the links - This was thekind of information that made me panic in the first place! Plus, the hematologist said "I hate to do it -- but I'll do it!"

    Actually, First, we've changed from ferrous sulfate to ferrous gluconate, still with the 500 mg of vit. c with each iron tab. In order to get the best from the stupid iron pills, you almost have to take them like fossamax - only with vit. C instead of completely alone. And she said that sometimes helobacter can block the absorption of iron. So we're doing the different kind of iron and the abx and rechecking and if that hasn't worked (but I'll bet it will!) then I'll have the IV iron.

    So, I'm not SO VERY worried about it anymore. I think I will make sure I've got a living will and all that lined up in the meantime, though!

    Thanks!!

    Love

    Dennie
  14. by   globalRN
    WHERE I WORK, IRON DEXTRAN IS GIVEN FIRST AS A TEST DOSE ; 30 MIN WAIT; IF ALL IS WELL ....THE FULL DOSE OVER ABOUT 4 HOURS.

    IRON SUCROSE(VENOFER) DOES NOT REQUIRE A TEST DOSE AND CAN BE GIVEN UP TO A MAX/DOSE /VISIT OF 500 MG ....SO IF IRON DEFICIENT MAY REQUIRE MORE VISITS/
    HAD ONE BAD VENOFER REACTION IN A PATIENT WITH MULTIPLE HEALTH CONDITIONS AND MULTIPLE ALLERGIES.

    REACTIONS: SEEN MANY ....CAUSE MY JOB IS TO DEAL WITH THE REACTIONS. TEST DOSES ARE ONLY GIVEN IF THE MD/NP IS AVAILABLE. I FOUND GIVING PREMEDICATION WITH ANTIHISTAMINE REALLY HELPS. DURING SOME REACTIONS I HAVE GIVEN VENTOLIN AS WELL. SO FAR, NEVER HAD TO ORDER EPINEPHRINE/GIVE EPINEPHRINE.

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