iv iron

[cookie2008]

I went incenter for 4 hours to have the iv iron because I cant do it at home insurance reasons, when I was finished I stood up for them to do my blood pressure I got hot and dizzy I sat back down was nauseas sweating and dry heaves, I know we didnt take off to much fluid, when I got in the car my feet was starting to swell and when I walked my legs felt spongy, I know I was having a reaction to the iron, the whole night I was sick and the following day.  I did call my neph and explained to him what happened.  Has anyone have an experience like this with the iv iron.

[jbeany]

Did they give you a partial dose and wait 30 minutes to see if you had any reaction?  They are supposed to do this every time.  They should also run some kind of a Benedryl drip at the beginning as well, to fend off any minor allergic reactions.

[RichardMEL]

That's what they do at my unit. You have a "test dose" and they do BP's every 10 or 15 minutes (over an hour) to see if you're reacting or not. I'm surprised they didn't do this with you. It could well be you've reacted to the iron - definitely discuss it with the unit/neph.

[YLGuy]

They used to push a little and then wait to push the rest.  Now they push it all at once.  I always have gum ready. As soon as they push it, all I can taste is the iron. I have never had a reaction to it.

[Dianejt]

What are some of the reactions from iron? They have been giving Frank iron sometimes. He is so new (5 weeks) that I'm still trying to figure out side effects.

[paris]

Any time I have had the 4 hour iron infusion, they have always done the pretest, waited for 30-60 minutes and then started the iv.  It does sound like an allergic reaction.    I haven't had the shot type. Only the slow iv infusion.   Hope they check this before you ever need another one. 

[Riki]

I have never had any trouble with the IV iron, but I remember, after my last transplant, I was getting injections, and I remember them making me lay down for 30 mnutes after each injection just to ensure there were no reactions.  I get it now, along with arenesp, every 2 weeks during dialysis

[cookie2008]

They slowly gave it to me over the 4 hours while I was on the machine, It was a high dose, I go back on Friday to get another dose, I am going to tell them to see if there is something else I can use.  Ive had iv iron before and never reacted but it was a small dose.

[sullidog]

I just get the one injection along with my epo. I can taste it but no reaction.

[Riki]

I think what I get is 200cc and it runs in over an hour.  Cookie, I don't know what they give you there, but what they give me is called Venifer, and I've only been getting it since I started hemo in December 2008.  I've never had any kind of reaction to it, and I'm a weird one.  I always have odd reactions to stuff

[del]

My husband uses venefer every 2 weeks.  he does nocturnal home hemo and it runs in over a one hour period at the beginning of treatment. The first time he had it he was doing in center hemo and they just ran in a little at a time to see if there would be a reaction.  A lot of people do have reactions to it.  He has never had a problem.

[Zach]

I find that mixing the I.V. iron in a saline bag (200 cc) and dripping slowly helps prevent some of the side effects.

Here is some additional information on IV Iron, from the Renal Fellow Blog:
http://renalfellow.blogspot.com/2009/08/iv-iron-preparations.html

Friday, August 7, 2009
iv iron preparations

"Because of the generally poor GI absorption of iron in the setting of ESRD, iron supplementation in dialysis patients is now carried out by intravenous formulations of iron complexed to various carbohydrates. The idea is that these carbohydrate moieties can function as "molecular shields", allowing for the safe delivery of iron to its target tisues while simultaneously preventing iron-mediated oxidative damage. Here are some of the main iv iron formulations and their unique attributes:

1. iron gluconate (Ferrlicit). In my limited experience, it appears to me that Ferrlicit and Venofer control the lion's share of iv iron formulations in U.S. dialysis centers. A typical course of Ferrlicit typically given in the ESRD patient is 125mg iv qdialysis session x 8 doses.

2. iron sucrose (Venofer). Also a popular option, the typical dosing for Venofer is 100mg iv qdialysis x 10 doses. Both Venofer and Ferrlicit offer fairly rapid release of iron. Also, Venofer is FDA-approved for iron repletion in non-dialysis-dependent CKD patients whereas Ferrlicit is not.

3. iron dextran (Dexferrum, Imferon): this is not used much anymore because of a significantly higher risk of anaphylactic reactions than the more modern Ferrlicit and Venofer. Iron dextran was typically given as a smaller "test dose" prior to giving the full dose, as a precaution against anaphylaxis.

4. low-molecular weight iron dextran (CosmoFer, InFed): it is important to distinguish low-molecular weight dextran from high molecular weight dextran because its risk of adverse events is so much lower.

5. ferumoxytol (Feraheme): this is a newly-released formulation of "iron oxide nanoparticles." Sounds very space-age, doesn't it? The reported advantage is that it can be given in large bolus doses--thus making it preferable for the treatment of iron deficiency in CKD, where a patient would otherwise be required to make multiple trips to an infusion center to get their Venofer or Ferrlicit. Further assessments of safety and efficacy are still needed."
~~~~~~~~~~~~~~~~~

There are two blood tests that assist in determining if one needs IV iron:

Ferritin, which should be more than 100 ng/ml and less than 800 ng/ml
Transferrin Saturation, which should be between 20% and 50%.

[cookie2008]

I talked with my home hemo nurse and I wont be having that type of iv iron again, we will have to go back and use the one Im used to.