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IRON

What is Monoferric?

Monoferric® (ferric derisomaltose) is a specialized intravenous (IV) iron medication used to treat
iron deficiency and iron deficiency anemia in adults. Unlike oral iron supplements, which can
take months to replenish stores and often cause digestive issues, Monoferric delivers a
concentrated dose of iron directly into the bloodstream. This allows for rapid absorption and can
often restore iron levels in just one or two sessions, making it a highly efficient option for those
who need fast results or cannot tolerate oral iron.

Common Symptoms Monoferric Can Treat

If you are experiencing any of the following, an iron infusion may help restore your baseline health:

  • Energy & Cognitive: Profound fatigue, “brain fog,” mood changes, and sleep disturbances.
  • Cardio-Pulmonary: Shortness of breath, heart palpitations, and reduced exercise tolerance.
  • Physical Signs: Cold hands or feet, restless legs (RLS), hair loss, brittle nails, and pale skin.
  • Other: Ice cravings (pica).

The Infusion Process

  1. Bloodwork: Lab work is normally ordered by your physician. To qualify, you must have bloodwork (CBC, Ferritin, and TSAT) completed within the last 3 months.
  2. Eligibility: You are generally eligible if your labs show Ferritin < 100 ug/L, Hemoglobin (Hb) < 110 g/L, and TSAT < 20%
  3. Insurance & Pharmacy: Your doctor faxes the prescription to Capsule Pharmacy. They will verify your insurance coverage and call you to discuss medication costs and
    eligibility.
  4. Booking Your Visit: Once Capsule Pharmacy confirms you are eligible and you choose to proceed, Vitadrip IV will call you to schedule your appointment.
  5. Walk-In Option: We also accept walk-in patients who obtain medication by means other than Capsule Pharmacy, provided you meet lab requirements and handle the medication safely (stored at 15–30°C and not shaken).

Clinic Hours & Pricing

  • Booking Times: Infusions are scheduled Monday through Friday, with start times between 10:15 am and 3:00 pm, depending on availability.
  • Medication Cost (Insurance vs. Out-of-Pocket):
    ○ Most private insurance plans provide coverage for Monoferric, and if you meet
    the requirements, the cost is often fully covered or very close to it.
    ○ For those paying entirely out-of-pocket, the full medication costs are: 500 mg
    ($260), 1000 mg ($508), 1500 mg ($756), or 2000 mg ($1,004).
  • Infusion Fee: There is a $200 infusion fee per appointment.
    Note for 2000mg Dose: To ensure safety, this dose is split into two separate appointments, resulting in a $200 infusion fee for each session.
    HSA Coverage: This fee can likely be covered through a Health Spending Account (HSA).

Indication and Lab Requirements

We accept referrals for adults (18+) who meet the following clinical profiles:

Primary Approved Indications

  • Iron Deficiency Anemia (IDA): Low Hb with Ferritin < 30 ng/mL
    (or < 100 ng/mL if TSAT < 20% in chronic disease).
  • Non-Dialysis CKD (NDD-CKD): Ferritin ≤ 500 ng/mL and TSAT < 30%
    (if intolerant/unresponsive to oral iron).

Off-Label Clinical Uses

  • Iron Deficiency without Anemia: Symptomatic patients (fatigue, brain fog) with low iron stores.
  • Restless Leg Syndrome (RLS): Ferritin ≤ 75 ng/mL with associated symptoms.

Clinical Workflow

Physicians are requested to order a comprehensive iron panel, including CRP (C-Reactive
Protein). Because ferritin is an acute-phase reactant, CRP is crucial to rule out systemic
inflammation that can falsely elevate ferritin and mask a true deficiency.

  1. Bloodwork: Ensure the patient has completed the necessary labs. Capsule Pharmacy
    has access to Netcare, so you do not need to fax lab results.
  2. Referral: Fax the completed prescription template to (587) 387-7252.
  3. Pharmacy Navigation: Capsule Pharmacy will review the labs via Netcare, verify
    insurance coverage, and contact the patient to discuss drug access.
  4. Clinic Booking:  Once the patient is cleared and agrees to proceed, Vitadrip IV will
    contact them to book the infusion.
  5. Walk-Ins: We also accept patients who provide their own medication, provided they
    meet all lab and safe-handling requirements.

Safety, Risks & Monitoring

  • Iron Staining Mitigation: We ensure vein patency using a saline lock before initiating
    the infusion to minimize the risk of permanent iron staining.
  • Anaphylaxis Monitoring: While rare (~1/200,000), we monitor for severe allergic
    reactions. Our nursing team is trained to initiate emergency reaction protocols
    immediately.
  • Acute Management: Our nursing team (LPN/RN) monitors for the Fishbane Reaction
    (~1%) and other side effects like nausea, headache, or dizziness.
  • Emergency Readiness: We maintain comprehensive protocols for reactions and have
    doctors on standby to assist with emergency management if necessary.
  • Contraindications: Referrals for pregnant patients or those with a history of IV iron
    hypersensitivity are not accepted.