Iron supplementation in heart failure

In patients with heart failure and iron deficiency (ID), oral iron supplementation is ineffective due to very poor absorption. Therefore, intravenous iron supplementation is the only therapeutic approach which has been proven to be safe and effective in patients with heart failure and ID confirmed by blood tests. The majority of evidence is related to the intravenous iron preparation ferric carboxymaltose.

The dose of intravenous ferric carboxymaltose administered to a patient is calculated based on body weight and haemoglobin level, and varies between 500 and 2000 mg. If the total calculated dose of iron required exceeds 1000 mg, its administration is split into two sessions separated by 4-6 weeks. Ferric carboxymaltose is administered as 15-minute intravenous infusion of iron dissolved in 100 mL of saline. This therapy can be safely delivered both in hospital and ambulatory settings.

Intravenous iron supplementation in patients with heart failure and ID has been proven to reduce the symptoms of heart failure, improve quality of life, increase exercise capacity and skeletal muscle strength as well as reduce the risk of recurrent hospitalisations.

The effect of intravenous iron supplementation on iron status should be checked by a blood test approximately 3 months after the last administered dose. After a patient has received the full dose, periodic screening for ID should be performed according to the Doctor’s recommendation.

Also known as:

• Ferric carboxymaltose

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ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers. is a European Society of Cardiology website

The website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

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