IV iron infusions are not “one size fits all”. Different IV iron formulations have different licensing, dosing limits, and monitoring considerations. At The Health Suite Leicester, we run two separate pathways:
- Adults (18+): we primarily use Monofer® (ferric derisomaltose)
- Young people (14–18): we use Ferinject® (ferric carboxymaltose) as part of a specialist-led pathway
Why do we use different IV iron medications?
The decision is usually based on:
- Age and licensing/data in that age group
- How much iron is needed (dose requirement)
- How many visits are likely to be needed
- Individual safety considerations (including phosphate risk and other comorbidities)
Monofer (ferric derisomaltose) – why we prefer it for adults
In adults, our priority is safe correction with as few visits as possible.
Key reasons:
1) “One-stop” dosing is often possible: Monofer can often deliver a full replacement dose in one infusion (dose-dependent), so many adults can avoid repeat appointments.
2) Phosphate considerations: Some IV iron preparations are associated with low phosphate (hypophosphataemia). Comparative studies show ferric derisomaltose (Monofer), is associated with a much lower rate of hypophosphataemia than ferric carboxymaltose(ferinject).
This doesn’t mean monitoring is never required—but it does mean phosphate issues are less likely in many low-risk adult patients when ferric derisomaltose (Monofer)is used.
3) Practical clinic workflow: A nurse-led assessment + structured blood review + safe infusion + follow-up testing is a sensible model for many adult cases.
Ferinject (ferric carboxymaltose) – why we use it in ages 14–18
In young people, our priority is a specialist-led approach and using an option with established paediatric data and dosing guidance.
Key reasons:
1) Paediatric licensing and data: Ferinject has established dosing guidance and published paediatric study data in children and adolescents.
2) Separate governance and monitoring pathway: Ferinject carries a known risk of hypophosphataemia and, rarely, hypophosphataemic osteomalacia. This is why we use a specialist-led pathway and discuss phosphate monitoring clearly as part of consent.
What about safety and allergic reactions?
All IV iron preparations can rarely cause serious allergic reactions. This is why infusions should be given in a medical environment with trained staff and appropriate monitoring after the infusion.
Which one is “better”?
Neither is universally “better”. The best choice is the one that:
- It is appropriate for the patient’s age group
- Can safely deliver the required dose
- Fits the patient’s medical history and risk profile
- Includes the correct monitoring plan