How do you get your IV meds such as heparin, epo and zemplar on home hemo?
On the Fresenius Machine there is a heparin pump which delivers the heparin.
EPO lots of home patients just give themselves the needles. If you want to use the machine we just inject in into the venous med port. Iron I fill a syringe and also slowly inject this into the venous med port.
My unit does not allow me to “inject” iron through the dialysis machine.
I have to receive it at clinic appointments. I was wondering how many home patients are able to give it themselves?
I plan on asking my nurse why I am not able to. (I know I was told once, but unfortunately my memory eludes me!)
I have to go incenter to get my iron too. I was told that no matter how often you have received IV iron there is still a chance you could have an alergic reaction. I think there is a type of iron that somehow gets around this - Marty do you know the “brand” of iron you use? I think I get Ferlicit but I may be misremembering.
I gave myself heparin and iron on the Fresenius and on the NxStage but the iron had to be given over a period of at least 10 minutes. the way I did it was to give one cc at a clip till it was all done. because I usually got distracted during the treatment it usually took way longer than 10 minutes but I always got it done.
Do you remember what brand of iron you used spiderwomen?
Bill, I am positive we use Ferrlicit and administer it slowly just as spider woman indicated. I give 1/2 cc every 5 minutes. I am also sure I wouldn’t have to give it quite this slowly but I always error on the side of caution.
I was using Venofer, never had any bad reaction but I took it slowly.
often wondered if it would make a difference if I just injected it all at once but never did.
Michael also gets his iron (Venofer) at home. And starting tomorrow, we’ll also be giving him Hectoral at home too. The problem for a lot of patients, I believe, is that Medicare doesn’t pay for these drugs if administered at home. In our case, my group insurance which is secondary picks it up, but not everyone is that fortunate.
I give my husband Ralph Venofor also, very slowly in the venus port.
He also takes Hectoral 1- 3 times a week. As for EPO we get it from the center and give it 3 times a week.
The Venofor is thru our drug company and it does not cost us a co-pay. Any thing that is given by IV there is no charge.
I take Venofer IV, but I have heard most states Medicare doesn’t cover IV drugs (I have Medicare, plus private insurance in Texas)
I give my iron & epogen during dialysis, but the iron I have to give slowly, usually in the last hour, diluted 1/2 with saline, in about 10 min. increments to make sure there is no reaction.
HI, My husband uses the heparin pump on the fresenius machine to administer his iron in the last hour of his dialysis. The heparin is turned off an hour before the end of treatment. We fill a 20ml syringe with 8 mls of saline, then 2 mls of iron. The rate is set at 10.0/hour. set timer to 1 hour, ( on heparin pump) Then, remove the syringe with heparin and replace it with the iron filled one. It finishes just before the end of treatment. Does anyone else do this?
the epo is administer via the venous med port.
Queenie, We don’t administer the Iron the way you do, but I think your way would be a lot easier.
I used to administer the iron myself, slowly such as Marty. It went in through a port and if I recall we had to inject a small dose at first, wait a certain amount of time, in case there was a reaction. Then inject the rest, slowly I forget the amount of time but it was a certain amount every 2 minuttes or so. Heparin was alway injected into a port at the start of TX. We didn’t use a heparin pump. The amount injected lasted the whole TX. It was however, only 4.5 hours.
I’ve never heard of doing it this way Queenie. It sounds like an interesting way of doing it. In my case, they want us to inject 4ml of Venofer every minute for 5 minutes. It has to be done via attaching a 20ml syringe to the medication line on the venous air chamber.
Foundation for IgA Nephropathy
Found this thread about the various ways home patients get IV iron. But no one has said if one has to go in-center to get iron using a IV stand with pump( a procedure done apart from a dialysis tx) where the needle should be administered. We are trying to understand if the needle should go in the access vein or somewhere else. Does anyone know if it is safe to administer iron into the access vein with a butterfly type needle apart from the way it would normally be done through the lines on a dialysis tx? Have never had any needles but dialysis needles put in access so wonder if anyone else has experinced a needle put directly into access to give iron or for anything else?
Bill, We started out using the Ferrlicit but were switched to Venofer. The switch didn’t occur because of the Iron it occured because of the bottle. On the Ferrlicit you had to break the top off the bottle and there was a possibility of small shaving of glass falling into the Ferrlicit and getting cut. on the Venofer the cap is like the heparin bottles. Just pop the top and insert a needle into the top. We give it the same as Pierre through the med port on the venous side which goes into the venous drip chamber.
To answer the question on how it was given during an in-center treatment. If I remember correctly dad received his through his catheter.
There has been some discussion about this at my home training unit. In general they have a stading policy that you should never use the fistula for anything other than dialysis. However, when I go to get iron I usually am not running so as you say they just use a small gauge (24 gauge?) needle. We talked about it and no one could come up with a downside - other than infiltrating, and I have to say, I did the cannulation and I can’t see how I’d miss with such a tiny needle.
So yes, when I get iron only incenter I use my fistula.
Thank you…this is what I wanted to know. Just had never heard of this being done before and wanted to be sure it is safe.
Does anyone know if it is ok to give iron, zemplar and epo at the same tx? If so, should there be some time inbetween each med or does it not matter?