Traps for the unwary

November 2010

Clinical

Intravenous iron replacement

Management in general practice

Volume 39, No.11, November 2010 Pages 839-841

Mark Naim

Jennifer Hunter

Background

Iron deficiency is one of the most common nutritional deficiencies in Australia, and remains one of the most underdiagnosed conditions in general practice. The consequences of this condition can be subtle and the cause is often multifactorial.

Objective/s

The aim of this article is to review the safety of parenteral iron replacement therapy, and specifically intravenous infusion, in the general practice setting. The results of a recent clinical evaluation of 43 consecutive adult patients are reported.

Discussion

Intravenous iron polymaltose infusions are commonly used in the hospital setting with low rates of reported adverse reactions (including low rates of anaphylaxis and anaphylactoid reactions). In a primary care setting, patients were given low dose intravenous iron polymaltose as a slow injection diluted with normal saline, following a diagnosis of iron deficiency or iron depletion, with or without anaemia. Injections were given at intervals no more frequently than weekly. Serum ferritin levels were monitored following treatment, and as routine follow up. A total of 89 injections of intravenous iron were used in 43 patients. No serious adverse reactions occurred. The administration of low dose parenteral iron polymaltose in the primary care setting is well tolerated and is potentially a cost effective alternative to specialist care and hospital admissions.

Iron deficiency is one of the most common nutritional deficiencies in Australia and remains one of the most underdiagnosed conditions in general practice.1 It is estimated that about 8% of the premenopausal adult female population has biochemical iron deficiency, with less than one-quarter being anaemic.1 The consequences of this condition can be subtle and the cause is often multifactorial.

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Correspondence afp@racgp.org.au

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