This webpage is intended for UK and IE Healthcare Professionals only.
Prescribing information can be found at the bottom of this webpage.
For patients ≥18 years for treatment of iron deficiency when oral iron preparations are ineffective or cannot be used or where there is a clinical need to deliver iron rapidly. The diagnosis must be based on laboratory tests.
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Sign Up HereMonofer: the power of...
... to give your patients the iron they need in just ONE visit.*8
*Up to 20 mg/kg body weight
See how Monofer works - view the Mode of Action video.
Dr Caitlin Scott provides a physician’s perspective of using iron.
Watch to find out more about IV iron-induced hypophosphataemia.
IV iron in heart failure
Iron deficiency is common and a strong predictor of mortality in systolic heart failure with reduced ejection fraction (HFrEF).9
IV iron can improve outcomes in patients with heart failure (HF) and iron deficiency.10
A meta-analysis of five randomised controlled trials (RCTs) in 509 patients with HF and iron deficiency demonstrated that IV iron (vs placebo):10
Alleviates HF symptoms
Improves exercise capacity
Improves patient QoL
QoL: Quality of life
Iron deficiency and IDA should be considered clinically important targets for IV iron therapy in HFrEF.10
The analysis also found that IV iron may improve:10
All cause mortality or CV hospitalisation
(p<0.0001)
CV: cardiovascular
CV mortality or hospitalisation for worsening HF
(p=0.0001)
However, RCTs powered to explore hard endpoints with IV iron preparations in congestive heart failure are needed.
Learning resources for IV iron in heart failure
Professor Paul Kalra
Consultant Cardiologist, Portsmouth Hospitals NHS Trust.
Also Chief Investigator for the IRONMAN study.
The IRONMAN study was partly funded with an unrestricted grant from Pharmacosmos UK
Iron deficiency in CHF:
A challenge that needs to be met.
Management of iron deficiency in CHF:
Our current understanding.
Introducing IRONMAN:
An important outcomes study.
Managing iron deficiency in HF:
Tips from a busy cardiology clinic.
CHF: congestive heart failure
IV iron in obstetrics
Low interpregnancy interval can lead to chronic iron deficiency and anaemia.11,12
The downward spiral of iron deficiency and anaemia in pregnancy.
Figure adapted from Gupta, et al.11 and Millman N, et al.14
If iron stores are not restored soon after childbirth, then the adverse effects of post-partum iron deficiency/anaemia may continue into subsequent pregnancies.13
Interpregnancy interval <1 year increases risk of iron deficiency.14
Treatment with 1000 mg iron may not sufficiently replenish depleted stores, leading to a subtherapeutic response.*7, 15
Addressing iron deficiency in a single visit minimises repeat visits and patient exposure to face-to-face interactions and the hospital environment.7
Monofer is the only fast IV iron that can address IDA during pregnancy in single dose administrations of >1000 mg, up to 20 mg/Kg, based on booking/pre-pregnancy weight.†16,17
*1000 mg would only be correct dose for women with booking weight < 70 kg and Hb at least 100 g/l.
† Monofer, like other IV irons, should not be used in the first trimester. Iron deficiency anaemia occurring in the first trimester of pregnancy can in many cases be treated with oral iron. Monofer should not be used during pregnancy unless clearly necessary.8
In a study conducted to evaluate the IV iron service provided to pregnant women by the haemotology team at a single hospital, 121 pregnant women were retrospectively analysed in their 2nd or 3rd trimester and referred to the IV iron clinic during the audit period (September 2014 - April 2017)16
Monofer was administered in single doses up to 20 mg/kg antenatal booking weight.16
Monofer doses provided:16
- 108/121 patients (89.3%) received a single infusion of Monofer, while 13/121 patients (10.7%) received two or three infusions
- The mean single Monofer dose was 1173 mg, and 59.3% of patients received a dose >1000 mg
Monofer increased Hb and ferritin levels in pregnant women with IDA16
59.3%
of women received a Monofer dose >1000mg.16
89.3%
of women received one infusion of Monofer.16
A single, high dose of Monofer can address IDA during pregnancy16,17
Learning resources for IV iron in obstetrics
Laura Stewart-Maunder, Midwifery Sister, Antrim Area Hospital provides a guide to treating iron deficiency anaemia with IV iron in obstetrics.
IV iron in surgery
Pre-operative anaemia is associated with greater post-operative transfusion need, morbidity and mortality, (National Institute for Health and Care Excellence (NICE) Quality Standard 138).18
Up to 90% of patients may have anaemia after major surgery.19
Patient blood management (PBM) aims to minimise blood transfusion.20
- PBM will play a key role as normal services resume - helping in optimal use of blood supply.21
- IV iron is an integral part of PBM - as an alternative to blood.20
- NICE recommends a 14-day period of self isolation prior to surgery - Treating patients with Monofer can help avoid repeat visits for iron correction during this period.22
NICE guidance:
Use of IV iron should be considered as an alternative to blood for peri-operative anaemia management23
- Infusion of red blood cells has a role to play in the management of patients who are severely anaemic (Hb ≤70 g/l)24
- However, serious risks associated with blood transfusion include infection, fluid overload and incorrect blood transfusions being given24
Monofer is the only fast IV iron that can be administered in single doses >1000mg, up to 20mg/kg, giving you the potential to optimally treat patients prior to surgery.1
Learning resources for IV iron in surgery
IV iron in
chronic kidney disease
In patients with chronic kidney disease (CKD), untreated anaemia is associated with reduced health-related quality of life and exercise capacity, and increased morbidity and mortality.25,26,27
Figure adapted from Gupta, et al.11 and Millman N, et al14
In the majority of patients, 1000 mg of IV iron may not be sufficient to replete iron stores; 1500 mg may be more suitable for iron repletion in patients with iron deficiency anaemia.28
Monofer allows administration of 1500 mg in a single infusion for patients weighing ≥75 kg.8
Learning resources for IV iron in chronic kidney disease
Professor Sunil Bhandari
Consultant Nephrologist/Honorary Clinical Professor, Hull Royal Infirmary
Why manage anaemia in CKD?
Why and how to treat full iron need in CKD.
How to deliver iron in CKD.
Safety of intravenous iron in therapy in CKD.