Iron Injections/Iron Infusion (Ferinject)

Iron injection is a quick and simple procedure to treat iron deficiency for patients where oral iron tablets have been ineffective, poorly tolerated, or are inappropriate. The whole procedure takes 45 - 60 minutes, but the injection only makes up 15 minutes of this and the rest is preparation and observation time - so make sure you bring a book! Iron Injection is:

  • Quick: Takes about an hour instead of months of oral treatment.

  • Easy: No need to remember to take a tablet every day.

  • Economical: Cheaper than 12 months of oral iron tablets (and generally lasts longer), comparable out-of-pocket price to 6 months of daily Maltofer® or Ferrograd-C®, and usually hundreds of dollars less than having it done though a hospital.

Who Can Have an Iron Infusion?

You will need to have the following blood tests, and meet the listed criteria in order to be eligible for iron infusion

  • Low iron stores. Ferritin must be less than 35 or if you have chronic heart failure less than 100.

  • Blood count. Haemoglobin needs to be checked as it is used in the calculation of your iron dose.

  • Liver function tests. Liver enzymes must be normal or it may not be safe for you to have the iron medication.

  • Phosphate. Phosphate must be above 0.8 in order for iron to be safely given without causing hypophosphataemia (low phosphate).

We require you to provide copies of these blood results prior to your appointment.

Can you have an iron infusion if you’re pregnant? Yes! As long as you are between 16 and 36 weeks pregnant. We cannot give iron infusions to women in early (0 - 16 weeks) or late (36 + weeks) pregnancy. If you’re in late pregnancy and need an iron infusion, your obstetrician can organise this at hospital for you.
Can older children have an iron infusion? Yes! Most doctors will not give iron to children under 14. However iron is a special interest of Dr. Tosch and she is experienced with giving iron to children aged 12 and up. The most important thing is that they’re willing! If your child is under 12 and has been recommended an iron infusion, this will need to be arranged with your specialist in a hospital.

How to Prepare for an Iron Infusion?

  • Remember to bring your iron vials along to the appointment; without the vials there is nothing to inject/infuse you with! Your GP should provide you with a prescription for Ferinject at the time they recommend an infusion. You can buy this from the chemist ahead of time, the vials have a very long expiry (usually 2 years!) and do not need to be kept in the fridge. Bring both 500mg vials, sometimes we only need to give one based on your required dose (calculated with blood tests and weight), but bring both just in case.

  • Eat a good meal prior - there is no need to be fasted - and make sure you drink plenty of water!

  • Wear clothing that can be easily rolled up to the top of your arm. We try to use the veins in the bend of your arm as they are bigger and it’s less painful here than the hand.

  • Bring along a book, earphones to listen quietly to music or a video, or some work to do - there will be 30 minutes after the infusion where you need to remain in the clinic being monitored.

My veins are deep, small, or tricky, what should I do? Being well hydrated will give us the best chance of finding your veins. It’s a good idea to drink at least one litre of water within the 2 hours prior to your appointment. Keep warm prior to your appointment as veins get smaller when you’re cold. Very rarely if your veins aren’t cooperating, we may reschedule your appointment and try again another day.

What Happens at the Appointment?

Iron Infusion/Injection Procedure
If not already done you will sign the consent form. Dr. Tosch will answer any questions you may have about the procedure before going ahead. A plastic cannula will be inserted into a vein in your arm, and the iron will be slowly, painlessly injected through this. After the iron injection you will be observed for 30 minutes and the doctor or practice nurses will check your arm and remove the cannula. You will be given an information sheet with tips to prevent hypophosphataemia (low phosphate) and may be given a follow up blood form.

Important Information

1) It is essential to have certain blood tests done prior to the procedure to ensure it is safe for you. These are Ferritin, Hb, LFTs, and phosphate.
2) Dr. Tosch cannot give Ferinject to children under 12, or women in early (0 - 16 weeks) or late (36 + weeks) pregnancy.
3) Headache is a common short term side effect. Most people go about their day as usual without any problems.
4) There are reports of Ferinject uncommonly causing long-lasting brown staining near the injection site - none of the over 500 patients injected by Dr. Tosch have ever reported this.
5) Just as with vaccines, there is a rare risk of anaphylaxis (life threatening face/neck/mouth swelling, shortness of breath), so it is important patients are observed in the clinic for 30 minutes afterwards - this makes up the majority of your hour with us.
6) Depending on your weight and dose of iron required, you may need two injections at least a week apart.

How to Book an Iron Injection/Infusion with Dr. Tosch

Dr. Tosch currently performs iron infusions at three locations across Sydney and the Central Coast. Click the links below for booking procedures for each clinic.

Mingara Medical in Tumbi Umbi (Tuesday, Wednesday, Thursday, and some Saturdays) - please call the clinic to book on (02) 4302 3333

Evergreen Doctors in Pymble (Fortnightly Fridays) - Click here to book online

Gordon Doctors (Fortnightly Fridays) - View information and referral form here