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Oral iron cannot cover the needs of all patients, and intravenous iron is sometimes required in selected patients, in consultation with a specialist. Current preparations can be safely administered in day patient treatment centres.
In patients with IDA, intravenous iron can provide rapid iron repletion when this is clinically important, such as to prevent decompensation or transfusion (and its associated hazards).
Uncertainty about when and how to administer IV iron preparations is an important contributor to underutilisation in patients with indications: where the benefits outweigh the risks (and are less than transfusion).
Timely consultation with a relevant expert is needed to ensure unnecessary transfusion is avoided and appropriate iron therapy is provided.