Ferric derisomaltose

How it works

It delivers iron within a carbohydrate complex that is taken up by the reticuloendothelial system, releasing iron for incorporation into haemoglobin and replenishment of stores.

Prescribing in practice

• Serious hypersensitivity and anaphylactic reactions can occur, so it must be given where resuscitation facilities are available and the patient observed during and after administration.
• Avoid in the first trimester of pregnancy and use parenteral iron in later pregnancy only when clearly necessary.
• Extravasation can cause persistent brown skin staining, so infusion site care is important.

Monitoring

Monitor the patient closely for hypersensitivity during and after the infusion and reassess iron indices and haemoglobin to gauge response.

Counselling the patient

• Report any rash, breathlessness, swelling or feeling unwell during or after the infusion immediately.
• Tell the team about any previous reactions to intravenous iron.
• Some people experience temporary symptoms such as headache or altered taste.

Evidence & guidelines

Intravenous iron is recommended where oral iron is unsuitable or replacement must be rapid, consistent with NICE and MHRA advice on managing iron-deficiency anaemia and parenteral iron safety.