Ferinject iron infusion during pregnancy

About Ferinject

Ferinject is a special type of iron preparation which we give through a drip. We use it instead of iron tablets.

About iron

Iron is important for red blood cells, which carry oxygen around the body. Insufficient iron can lead to your body producing fewer red blood cells. This is called iron deficiency anaemia (IDA). It can make you feel tired, dizzy, irritable, unable to sleep, and lead to dry skin or hair loss.

The cause of this anaemia is often a combination of things.  It can be linked to:

• not eating enough iron-rich foods
• not absorbing iron from your diet (malabsorption)
• bleeding
• an increase in how much iron your body needs.

Anaemia is more common in pregnancy, because your body needs three times as much iron when you are expecting a baby.

Why we recommend Ferinject

We recommend Ferinject to people who:

• are anaemic and have not responded to oral (by mouth) iron, or who have been made unwell by taking iron tablets
• have a medical condition where they cannot take tablets
• are anaemic following the birth of a baby
• have requested not to have a blood transfusion. Ferinject is not a blood product and does not have the risks associated with blood.

We can use Ferinject instead of blood unless you have an urgent need for blood.  Blood transfusions are safe, but there is a small risk of infection.

We will not give you Ferinject if you:

• have anaemia caused by deficiencies other than iron, such as B12, that has not yet been treated
• have been told by a doctor that you have ‘iron overload’
• have had an allergic reaction to iron given to you via a drip
• have had a serious problem with your liver.

How we give Ferinject

We usually give Ferinject when you are in the delivery suite, maternity ward or Day Assessment Unit.

• Before starting treatment, the midwife will check your pulse, blood pressure and temperature. If you are pregnant, they will check your baby's heartbeat.
• We will put a drip (thin tube) into a vein in your arm. The Ferinject infusion takes about 15 minutes. The midwife will check your pulse, blood pressure and temperature after the drip has finished.
• If you have not had your baby, the midwife will monitor your baby's heart rate before you go home.

The full treatment usually takes 1 hour. Most people go home afterwards, unless there are other reasons to remain in hospital.

The treatment does not affect your ability to drive.

After treatment

Some women will feel a little tired and their urine will be a darker colour the next day.

Most women notice that the symptoms of low iron levels such as tiredness, shortness of breath and dizziness get better within a few days.

Do not start any iron tablets or syrups for at least 5 days after your last infusion.

We will take a blood sample weeks or months after your treatment, to check if your body's iron stores are fully corrected.

You may need further treatment if you have ongoing issues with your iron levels.

Risks and side effects

Risks

• Ferinject can cause allergic reactions. This is uncommon (1 in every 100 cases).  Symptoms include breathing difficulty, dizziness, swelling in the mouth.
• It can cause a serious allergic reaction (anaphylaxis). This is rare (less than 1 in every 1000 cases).
• It can cause injection site reactions, including skin staining (due to the drug leaking outside the vein). Staining can happen in other parts of the body and can take a long time to resolve. It can be permanent, but this is uncommon (less than 1 in every 100 cases).

We will monitor you closely during and after your treatment, so we can manage any allergic reaction.

Very little Ferinject crosses into breast milk so you can safely breast-feed.

Side effects

As with all medicines, Ferinject can cause side effects.

Common side effects (less than 1 in every 100 cases) include:

• headache
• dizziness
• high blood pressure
• nausea.

Uncommon side effects (less than 1 in every 1000 cases) include:

• tummy upsets (vomiting, tummy pain, diarrhoea, constipation)
• flushing (redness or warmth), fast heart rate, low blood pressure
• muscle and joint pains, backache and muscle cramps
• tiredness, chills, chest pain, swelling, pins and needles
• high temperature, itching and rash.

Tell your healthcare professional immediately during the infusion if you experience:

• Pain, burning or heaviness of the arm where we are administering the infusion.
• Discomfort, swelling, pain or leakage in the area around the injection.

Speak to your GP if you experience any of the above symptoms after your discharge from hospital.