Ferric Maltol (Ferracru®) for the treatment of iron deficiency anaemia in inflammatory bowel disease Traffic light classification- Amber 2 Consensus of a local agreement between Primary and Secondary care Secondary care Responsibilities Secondary Fails at least two oral iron salt preparations and HB >9.5g/ dL- see below Start ferric maltol 30mg BD. Hb decreased Stop ferric maltol and consider IV Repeat FBC and ferritin at 1/12 to assess iron- refer to if Hb and ferritin are improving or have anaemia in IBD normalised pathway Hb and ferritin the same or increasing Request primary care to continue prescriptions for ferric maltol and repeat bloods at 3/12. Normalisation of Insufficient rise in Hb Hb and ferritin and ferritin Stop ferric maltol and recheck Refer to secondary care for haematinics in 3/12 consideration of IV iron- refer to anaemia pathway Approved by Nottinghamshire APC: August 2021 Review: August 2024 Ferric maltol inclusion criteria 1. Hb and ferritin failed to normalise with conventional oral iron salts but Hb no less than 9.5 g/dL 2. Deemed intolerant of conventional oral iron salts following an individual patient review by the clinician and side effects are unmanageable by reducing dose e.g: Constipation Diarrhoea Epigastric pain Faecal impaction Gastrointestinal irritation Nausea Exacerbation of IBD Ferric maltol exclusion criteria No previous trial of oral iron salts Hb <9.5 g/dL Haemochromatosis Iron overload syndromes Repeated blood transfusions Secondary care will be responsible for initiating ferric maltol and ensuring that patient is responding after 1 month of treatment prior to transfer to primary care. What increase would you expect over three months? At a dose of 60mg daily, normalisation of Hb and Ferritin would be expected in three months References: BNF accessed online June 2021 Ferraccru Summary of Product Characteristics. Accessed June 2021 Approved by Nottinghamshire APC: August 2021 Review: August 2024 .