Iron infusions ‘taking off’ in general practice

Doug Hendrie

20/11/2019 3:15:51 PM

The procedure is becoming a key part of general practice – and that is good news.

Dr Danny Byrne and iron man
Dr Danny Byrne (R) believes in the power of iron infusions.

Five years ago, iron infusions went from a six-hour hospital procedure to one that can be done in 15 minutes in a general practice.
The 2014 Pharmaceutical Benefits Scheme (PBS) listing of a much faster alternative drug, ferrous carboxymaltose (sold as Ferinject), has led to huge interest in general practice iron infusions – and the pace has not slowed.
That is according to Dr Danny Byrne, who is running a packed RACGP webinar on iron infusions, with 400 GPs signed up.
‘Iron infusions are taking off like wildfire in general practice,’ he said.
‘With the much smaller molecule [of ferrous carboxymaltose], it’s much safer to infuse rapidly with much less risk of anaphylaxis. So it’s got convenience, speed and safety.
‘It’s an incredibly satisfying procedure to be able to do for your patients and gets GPs back in the area of doing procedures. More and more GPs are doing this, as it’s more convenient for your patients.’
When performing infusions, GPs need IV access and resuscitation equipment on standby for very uncommon cases of anaphylaxis.
‘Anaphylaxis can still happen, but it’s just incredibly rare. We wouldn’t be doing this if it was dangerous,’ he said.
Dr Byrne said the speed and convenience of the procedure has been leading many patients to seek it from their GP.
‘For patients, having their usual GP doing the procedure at the practice is convenient and much quicker,’ he said. ‘They don’t have to take a day off work to go to a big hospital.’
Iron deficiency, Dr Byrne said, is the only required clinical indicator.
‘There’s a huge amount of iron deficiency in the community – mostly amongst women with heavy periods, and those on vegetarian or vegan diets, as well as a whole host of medical reasons,’ he said.
Dr Byrne stressed, however, that oral tablets should be tried in the first instance, as they are even safer than infusions.
‘We shouldn’t jump in because [infusions] are flavour of the month,’ he said. ‘But there are patients where the tablets are not effective, either because they can’t absorb them or they hate the side effects of constipation, abdominal pain and diarrhoea.’
Patients must be monitored for 30 minutes after the procedure to ensure no anaphylaxis reaction takes place.
Resources will be uploaded to the ‘GP community’ section of shareGP for those who were unable to access the webinar.
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Correction: This article previously stated there is no Medicare rebate for the procedure.

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Dr Penelope Susan Browne   21/11/2019 6:59:42 AM

I would recommend a more cautious recommendation about iron infusions. We have had a number of claims for the damage caused by permanent staining caused by extravasation of Ferrinject into the tissue during an infusion. Always warn of this risk and be sure that there is a good indication before using this treatment Oral iron does usually work.

JC   21/11/2019 8:00:13 AM

"Five years ago, iron infusions went from a six-hour hospital procedure to one that can be done in 15 minutes in a general practice."

No - as the article later comments there is also the additional 30 minutes of observations.