An intravenous iron for iron-deficiency anaemia
Ferric derisomaltose
An iron given into a vein to treat iron-deficiency anaemia when iron taken by mouth is not suitable or not enough.
What is Ferric derisomaltose?
Ferric derisomaltose is a form of iron given into a vein (intravenous iron) to treat iron-deficiency anaemia, where the body is short of iron and so makes too few healthy red blood cells. It is mainly used when iron tablets do not work well enough, are not tolerated, or cannot be used. It is given by a healthcare team in a setting where serious allergic reactions can be treated, because rare but serious hypersensitivity reactions can occur. Other points to know are that it can lower phosphate levels in the blood, and that it can cause a lasting brown skin stain if it leaks where the needle goes in.
Education and reference only. This is a plain-language guide to Ferric derisomaltose — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Ferric derisomaltose is an intravenous iron preparation, meaning iron that is given directly into a vein rather than taken by mouth. It is used to treat iron-deficiency anaemia, a common condition in which low iron stores mean the body cannot make enough healthy, oxygen-carrying red blood cells, leading to tiredness, breathlessness and pallor. It is chosen when iron tablets have not worked, have caused too many side effects, or cannot be used, or when iron needs to be replaced more quickly or in larger amounts. It is given by a healthcare team in a hospital or clinic.
How it works
Iron is needed to make haemoglobin, the substance in red blood cells that carries oxygen around the body. In iron-deficiency anaemia, low iron means the body cannot make enough haemoglobin. Ferric derisomaltose delivers iron straight into the bloodstream, where it is taken up and stored, then used to make new red blood cells. Because it bypasses the gut, it works for people who cannot absorb or tolerate iron tablets, and it can replenish iron stores efficiently. The benefit builds over days to weeks as the body uses the iron to make healthy red blood cells.
Company & origin
Originated / developed by: Specialist manufacturer.
An intravenous iron used in the UK to treat iron-deficiency anaemia, mainly when iron tablets do not work, are not tolerated or cannot be used.
Practical use
How to take Ferric derisomaltose
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by a healthcare team into a vein, in a hospital or clinic where any reaction can be treated.
- You will be watched during the infusion and for a period afterwards in case of a reaction.
- Tell the team straight away if you feel unwell during the infusion, such as flushing, breathlessness, dizziness or a rash.
- Tell the team if you notice pain, swelling or leaking at the drip site, as leaked iron can stain the skin.
- Attend any follow-up blood tests so your team can check your iron, blood count and, where needed, your phosphate level.
Weighing it up
Advantages & disadvantages of Ferric derisomaltose
Advantages
- Treats iron-deficiency anaemia effectively when iron tablets do not work, are not tolerated or cannot be used.
- Replenishes iron stores quickly by delivering iron straight into the bloodstream.
- Avoids the stomach upset and poor absorption that some people have with iron tablets.
Disadvantages
- Rare but serious allergic reactions can occur, so it must be given where they can be treated.
- Can lower the level of phosphate in the blood, which may need checking.
- Can leave a lasting brown skin stain if it leaks where the needle goes in, and it is a hospital or clinic treatment.
Practical use
Good to know
The most important safety point is that, like all intravenous irons, ferric derisomaltose can rarely cause serious allergic (hypersensitivity) reactions, so it is always given where staff and equipment are ready to treat such a reaction, and you are watched during and for a time after the infusion. Two other practical points are that it can lower the level of phosphate in your blood, which is sometimes checked, especially if you have repeated doses, and that if the iron leaks out of the vein where the needle is placed it can leave a long-lasting brown stain on the skin, so the team take care with the injection. Many people feel less tired as their anaemia improves over the following weeks. It is a hospital or clinic treatment, not something taken at home, and the team will explain how many doses you need.
Who should not take it / use with caution
- People who have had a serious allergic reaction to ferric derisomaltose or other intravenous irons should not receive it.
- It is generally avoided in early pregnancy and used with care later in pregnancy, under specialist advice.
- It is used with caution in people with certain liver, infection or allergy conditions, under medical guidance.
Monitoring
- Watching you during and after the infusion for any reaction.
- Checking your blood count and iron levels after treatment to see how well it has worked.
- Checking phosphate levels where appropriate, particularly with repeated dosing.
Side effects
- Nausea, headache, flushing or changes in taste around the time of the infusion.
- A low phosphate level in the blood, which may cause tiredness or, if marked, bone or muscle aches.
- Rarely, serious allergic (hypersensitivity) reactions, which is why it is given where they can be treated; a brown skin stain can occur if it leaks at the injection site.
Key interactions
- Iron tablets taken by mouth are usually stopped around the time of intravenous iron, as they add little and may upset the stomach.
- Tell your team about all your medicines, as your overall anaemia treatment is planned together.
- Your phosphate level may need watching, especially alongside repeated doses or other treatments that affect it.
Available as: A solution given as an infusion or injection into a vein by a healthcare team.
Answers
Ferric derisomaltose: frequently asked questions
What is ferric derisomaltose used for?
It is an iron given into a vein to treat iron-deficiency anaemia, mainly when iron tablets do not work well enough, are not tolerated, or cannot be used.
Why is it given in hospital or a clinic?
Like all intravenous irons, it can rarely cause a serious allergic reaction, so it is given where staff and equipment are ready to treat one, and you are watched during and after the infusion.
Can it affect my blood tests?
Yes; it can lower the level of phosphate in your blood, so your team may check this, especially if you have repeated doses.
Why might my skin stain at the drip site?
If the iron leaks out of the vein where the needle is placed, it can leave a long-lasting brown stain on the skin, so the team take care with the injection and you should report any leaking or pain.
How soon will I feel better?
The iron is used over the following days and weeks to make healthy red blood cells, so symptoms such as tiredness usually improve gradually rather than straight away.
The wider class
About Intravenous iron preparation
Ferric derisomaltose belongs to the intravenous iron preparation class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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