Iron Infusion at Home

The prescriber selects the product and the setting.

• Injectafer (ferric carboxymaltose) and Venofer (iron sucrose) can be given at home when the prescriber agrees. MedRx can send a skilled nurse from an accredited nursing agency to administer them.
• Feraheme (ferumoxytol): the label limits administration to settings where staff and treatment for serious allergic reactions are immediately available, with monitoring for at least 30 minutes after each infusion.
• INFeD (iron dextran): the label calls for a test dose before the first full dose, with staff and equipment on hand to treat a serious allergic reaction.
• Ferrlecit (sodium ferric gluconate complex in sucrose) is indicated for patients on hemodialysis and is given intravenously during dialysis sessions.

For Feraheme, INFeD and Ferrlecit, the prescriber determines where the infusion takes place. Each medication page lists its approved uses and how it is given.

Each IV iron product has its own FDA-approved uses:

• Injectafer (ferric carboxymaltose): iron-deficiency anemia in adults and children 1 year and older who could not take oral iron or did not respond well enough to it; iron-deficiency anemia in adults with CKD who are not on dialysis; and iron deficiency in adults with heart failure (NYHA class II or III).
• Iron sucrose (Venofer): iron-deficiency anemia in adults with CKD, with or without dialysis, and maintenance iron treatment in children 2 years and older with CKD.
• Feraheme (ferumoxytol): iron-deficiency anemia in adults who could not take oral iron or did not respond well enough to it, and in adults with CKD.
• INFeD (iron dextran): iron deficiency confirmed by laboratory tests, in adults and children 4 months and older, when oral iron could not be taken or did not work well enough.
• Ferrlecit (sodium ferric gluconate complex in sucrose): iron-deficiency anemia in adults and children 6 years and older with CKD on hemodialysis who also receive epoetin, a medication that stimulates red blood cell production.

A prescription is required.

1. The prescriber's office faxes or phones in a referral. The Iron Infusion Referral Form (PDF) should go with recent clinical notes and laboratory results.
2. MedRx's intake team verifies insurance benefits and obtains prior authorization when the plan requires it.
3. MedRx explains the patient's coverage and any expected out-of-pocket costs.
4. Medication and supplies are delivered to the patient's door at no charge. Next-day delivery is available; timing varies by location.
5. A skilled, trusted and licensed nurse from an accredited nursing agency administers the infusion at home and monitors vital signs and adverse reactions.
6. The prescriber sets the number of infusions. The nurse can collect blood samples for laboratory tests when they are ordered.
7. A MedRx pharmacist is available 24 hours a day, 7 days a week.

Serious hypersensitivity (allergic) reactions can occur with some IV iron products. The nurse monitors the patient throughout the infusion. When the prescriber orders it, the delivery includes an anaphylaxis kit: medications to treat a severe allergic reaction.

Before treatment, the prescriber may ask about previous reactions to intravenous or injected iron and order blood tests. Each medication page lists its own safety information.

In a medical emergency, call 911.

Health plans often require prior authorization for IV iron. MedRx's intake team checks coverage and works with the prescriber's office on the paperwork before the first delivery.

Where out-of-pocket costs are a barrier, MedRx helps patients find and apply for copay assistance, grants and other financial aid. Some manufacturers of IV iron also run support programs; each medication page names its program.

We fill Injectafer, Venofer, Ferumoxytol, INFeD and Ferrlecit.

Each has its own page: what it is approved for, how it is given, and how to start. See every medication we fill.

Read more about home infusion nursing.