Christchurch women’s hospital

Canterbury DHB
Women’s & Children’s Health
POST PARTUM INTRAVENOUS IRON INFUSION PROTOCOL
INDICATIONS
1. Anaemia Hb <100g/L and haemodynamically stable (blood transfusion not indicated) 2. Iron-deficiency anaemia Hb <110g/L and intolerant to oral iron e.g. some patients with CONTRAINDICATIONS
1. Hypersensitivity to iron polymaltose 2. First trimester of pregnancy 3. Uncontrolled bronchial asthma 4. Iron overload (e.g. haemochromatosis, thalassaemia) 5. Chronic polyarthritis 6. Ostler-Rendu-Weber syndrome 7. Infectious hepatitis 8. Infectious renal complaints in the acute phase Parenterally administered iron can cause allergic or anaphylactoid reactions. Facilities for cardiopulmonary resuscitation must be available. In the event of a serious allergic or anaphylactic reaction, administration of Ferrosig must be stopped, intramuscular adrenaline should be administered immediately and other supportive measures initiated. Intravenous promethazine and hydrocortisone should be available for immediate use in the event of a severe adverse drug reaction. Patients with bronchial asthma, with low iron binding capacity and/or folic acid deficiency are particularly at risk of an allergic or anaphylactoid reaction. ADVERSE EFFECTS

Systemic reactions: headache, nausea, vomiting, joint and muscle pains, faintness, tachycardia,
flushing, sweating, bronchospasm with dyspnoea, hypotension, dizziness and circulatory collapse.
Delayed systemic reactions: dizziness, syncope, a sensation of stiffening of arms, legs, or face,
chest and back pain, arthralgia, chills, fever, rash, urticaria, angioneurotic oedema and generalised
lymphadenopathy.
I have discussed possible adverse reactions with the patient:
Signed: ________________________________ Date: ________________
Created: June 2007
Page 1 of 2
W&CH/GL/M/0012
Developed by: Ruth Hughes, Consultant Physician
Canterbury DHB
Women’s & Children’s Health
Postpartum IV Iron Infusion Chart

Consultant: Date arranged for infusion: / / .
To calculate iron Dose:
(pre-pregnancy weight in kg) x (110 – current Hb g/L) x 0.24 + 500mg
Calculation:
(_______kg x (110 - ______ g/L)) x 0.24 + 500mg = _______ mg

NOTE: a 2mL ampoule of Ferrosig (Iron polymaltose) contains the equivalent of 100mg Iron
Prescriber’s signature
Time given
Prescription
Surname Print
FERROSIG: _______________ mg

Add to 1000mL 0.9% normal saline i.v.
Hydrocortisone
PREMEDICATION:
100mg i.v.
Promethazine
10mg p.o.
Infusion Regime/Rate
Observations
20mls/hr for 30 mins
(total infusion dose:10mls)
40mls/hr for 30 mins
(total infusion dose:20mls)
80mls/hr for 30 mins
(total infusion dose:40mls)
120mls/hr for 30 mins
(total infusion dose:60mls)
300mls/hr until the infusion is finished
NB: if side effects develop decrease the
infusion rate
Created: June 2007
Page 2 of 2
W&CH/GL/M/0012
Developed by: Ruth Hughes, Consultant Physician

Source: http://www.zinkhan.org/Hospitals-Services/Health-Professionals/maternity-care-guidelines/Documents/GLM0012%20Postpartum%20Intravenous%20Iron%20Infusion.pdf