A direct infusion order allows your physician to prescribe iron infusion directly. The Iron Deficiency Clinic involves an assessment by our Internist who will evaluate your condition, order infusion if indicated, and provide follow-up monitoring.

Providers can fax either a completed Iron Infusion Order Form (for direct infusion) or a referral to our Internal Medicine clinic. Our team reviews all incoming forms and contacts the patient to schedule.

Some people may have side effects from oral iron pills or cannot absorb oral iron into their body. It can also take many months for you to get the same dose of iron from oral iron as you can get from one dose of intravenous (IV) iron (iron given in the vein).

Health Canada has approved iron to be given in the vein (IV) for people who have iron deficiency anemia. Your doctor may suggest IV iron for iron deficiency anemia if you have side effects to iron pills, if iron pills have not worked, if you have severe
anemia, or if you are going for surgery very soon.

Iron deficiency anemia means:

• Low red blood cells – hemoglobin level less than 120 g/L (grams per litre).
• Low iron level – ferritin under 30 μg/L (micrograms per litre), or under 200 μg/L with iron saturation less than 20%.

Common side effects (about 1 person in every 20 may have these):

• low blood pressure (dizziness)
• muscle cramps
• joint pain
• headache
• injection site swelling
• chest discomfort
• nausea, vomiting and/or diarrhea

Serious allergic reactions (rashes, face swelling and wheezing) including anaphylaxis, are rare.

After you get IV iron, you will be watched for 30 minutes to make sure you do not have an allergic reaction or a drop in your blood pressure.

If you have any serious reactions after leaving the clinic, go to your closest emergency department immediately, or call 911.

Before your first dose of IV iron tell your doctor or nurse if you are allergic to any medications, including iron pills.

Three products are supplied by Sunnybrook’s pharmacy:

• iron sucrose (Venofer®)
• ferric derisomaltose (Monoferric®)
• ferric carboxymaltose ( Ferinject ®) 

You and your doctor will talk about which one is right for you.

You may need one or more doses which are given about one week apart. This will depend on how severe your anemia is and which IV iron product your doctor ordered.

• Venofer® is given in the vein over 1-2 hrs.
• Monoferric® is given in the vein over a 30-to-60-minute infusion.
• Ferinject ®   is given in the vein over a 30-to-60-minute infusion.

The infusion administration fee is $175. This fee may be covered by your private drug insurance plan, depending on your coverage.

There is a separate cost for the IV iron medication itself. This cost is usually covered:

• By your private drug insurance plan, if you have one, or
• By the Ontario Drug Benefit Program (ODB) if you are eligible for
  ODB coverage

Medications are sourced through our associated pharmacy team. We handle insurance exploration and payment coordination prior to your treatment. The IV iron medication will be delivered by pharmacy to our Infusion clinic

Our associated pharmacy will contact you for payment information (credit card, online payment or private insurance). Our pharmacy team actively explores coverage options for each patient. You will be fully informed of any coverage details and out-of-pocket costs before your appointment — no surprises.