What are the disadvantages of intravenous infusions?

September 26, 2025 •

5 min read

According to a 2018 study, up to 50% of peripheral IV catheter procedures may fail, highlighting some of the initial practical disadvantages of intravenous infusions even in routine care. However, the drawbacks extend far beyond simple insertion issues and include a range of local and systemic risks that demand careful consideration by both patients and healthcare providers.

Quick Summary

Intravenous infusions, while highly effective for delivering medication and fluids, carry inherent risks, including local complications like infection, phlebitis, and extravasation, as well as systemic issues such as air embolisms and fluid overload. They can also cause patient discomfort, allergic reactions, and may lead to long-term vein damage with frequent use, requiring a careful balance of benefits and potential downsides.

Key Points

Local Complications: The most common disadvantages include inflammation of the vein (phlebitis), leakage of fluid into surrounding tissue (infiltration or extravasation), and bruising (hematoma) at the insertion site.
Systemic Infection Risk: An IV line bypasses the skin's protective barrier, creating a direct path for pathogens into the bloodstream, which can lead to a serious systemic infection like sepsis if proper sterile procedures are not followed.
Rare but Severe Dangers: Though uncommon, severe risks include air embolisms blocking blood vessels and potentially fatal anaphylactic allergic reactions to the infused substance.
Fluid and Electrolyte Issues: Excessive fluid delivery can cause hypervolemia, leading to swelling and strain on the heart, while some infusions can disrupt the body's electrolyte balance.
Reduced Patient Quality of Life: The invasive nature of IV infusions can cause pain, anxiety, and restrict mobility, affecting a patient's comfort and daily life, particularly during extended therapy.
Long-Term Vein Damage: Repeated IV access over time can lead to vein scarring and damage, making future venous access increasingly difficult and challenging.
Higher Cost and Invasiveness: IV therapy is generally more expensive and invasive than oral medication, making it less suitable for conditions where an equally effective oral alternative exists.

Common Site-Specific Complications

Intravenous (IV) infusions are a cornerstone of modern medicine, but as an invasive procedure, they present a risk of localized complications at the insertion site. These are often the most immediate and visible drawbacks.

Phlebitis: Inflammation of the Vein

One of the most common issues, phlebitis is the inflammation of the vein where the catheter is placed. It can be caused by mechanical irritation from the catheter itself, chemical irritation from the infused solution (especially high-osmolality solutions like hypertonic dextrose), or a bacterial infection (septic phlebitis). Symptoms include localized pain, redness, swelling, and a hard, palpable cord along the vein. While often mild and self-resolving with warm compresses, severe cases can lead to thrombophlebitis, a painful condition involving blood clot formation.

Infiltration and Extravasation

These related complications occur when the infused fluid leaks into the surrounding tissue instead of flowing into the vein. Infiltration is the leakage of a non-irritating substance, often due to a dislodged catheter. Extravasation, more serious, is the leakage of an irritating or vesicant solution, which can cause significant tissue damage, blistering, and necrosis. The risk of extravasation is a major disadvantage, as it can lead to severe pain, tissue death, and even permanent scarring if not identified and treated promptly. Symptoms include swelling, coolness, and blanching of the skin around the insertion site, as well as a feeling of tightness or burning.

Bruising and Hematoma Formation

Following a venipuncture, minor bruising is common. However, if a blood vessel is damaged during insertion or upon removal of the IV, a hematoma—a localized swelling filled with blood—can form. While typically not serious, a hematoma can be painful, cause significant swelling, and prolong healing at the site.

Systemic and Medical Risks

Beyond local issues, intravenous infusions also pose a range of systemic risks that can affect the entire body. These risks underscore the need for administration by trained medical professionals in a controlled setting.

Risk of Infection

An IV line creates a direct pathway for bacteria to enter the bloodstream, bypassing the body's natural skin barrier. This can lead to a localized skin infection or, more dangerously, a catheter-related bloodstream infection (CRBSI), which can become a life-threatening systemic infection like sepsis. Proper sterile technique is paramount to minimize this risk.

Air Embolism

An air embolism is a rare but potentially fatal complication that occurs when a large volume of air enters the bloodstream and travels to the heart or lungs. The air bubbles can block blood flow, leading to heart attack, stroke, or respiratory failure. This risk is primarily associated with central lines but can also occur with peripheral IVs if air bubbles in the tubing are not purged correctly.

Fluid Overload (Hypervolemia)

Delivering fluids directly into the bloodstream at too high a rate or volume can lead to fluid overload, especially in patients with pre-existing heart or kidney conditions. This can cause a buildup of fluid in the body, leading to swelling, shortness of breath, and increased strain on the heart, making careful monitoring of fluid balance essential.

Allergic Reactions

Patients can have an allergic reaction to the infused medication or solution, which can range from mild symptoms like itching and rash to a severe, life-threatening anaphylactic reaction. Because the substance is delivered directly into the bloodstream, the reaction can occur very rapidly and requires immediate intervention.

Electrolyte Imbalance

In some cases, especially with high-volume infusions or specific electrolyte-containing solutions, an imbalance of electrolytes like sodium, potassium, or magnesium can occur. This can lead to serious health issues, including muscle weakness, confusion, or cardiac arrhythmias.

Comparison: Intravenous (IV) vs. Oral Administration


Feature	Intravenous (IV) Infusion	Oral Administration
Speed of Action	Immediate onset of effect as it bypasses digestion.	Slower onset, dependent on digestion and absorption.
Bioavailability	100% bioavailability; the full dose enters the bloodstream.	Variable bioavailability, influenced by digestion, stomach acid, etc.
Invasiveness	Invasive procedure requiring needle insertion.	Non-invasive and can be self-administered.
Patient Comfort	Potential for pain, discomfort, and limited mobility during infusion.	Pain-free and highly convenient.
Risk of Infection	Risk of catheter-related and systemic infection.	Minimal risk of infection related to administration.
Complications	Local complications (phlebitis, extravasation) and systemic risks (embolism).	Primarily gastrointestinal side effects (nausea, upset stomach).
Cost	Generally more expensive due to equipment, administration time, and monitoring.	More cost-effective for many medications.
Suitability	Best for critical care, rapid delivery, or poor absorption.	Preferred when clinically appropriate for patient convenience and safety.

Long-Term and Practical Considerations

Aside from acute medical risks, IV infusions also have practical and long-term disadvantages.

Vein Damage

For patients requiring frequent or long-term IV therapy, such as those with chronic illnesses, repeated needle insertions can cause scar tissue to build up. This can lead to permanent damage, making future IV access more difficult and painful, a condition sometimes referred to as 'venous depletion'.

Cost and Accessibility

IV infusions are significantly more expensive than oral medications due to the specialized equipment, medication preparation, administration, and monitoring required. This cost, coupled with the need for trained personnel and often a clinical setting, can make IV therapy less accessible for some patients compared to oral alternatives, particularly for non-critical conditions.

Psychological and Mobility Impact

For some patients, the fear of needles (trypanophobia) or the discomfort and anxiety associated with the procedure can be a significant psychological burden. Furthermore, during an infusion, a patient's mobility may be restricted, which can affect their quality of life, especially for those undergoing prolonged treatment.

Conclusion

While intravenous infusions offer undeniable benefits in terms of rapid and efficient drug delivery, it is crucial to recognize and understand their inherent disadvantages. From common site-specific issues like phlebitis and extravasation to more serious systemic risks such as infection and air embolism, the procedure is not without its perils. Long-term use can also lead to vein damage, and the higher cost and invasiveness make it less preferable than oral administration when the latter is equally effective. Patients and healthcare providers should weigh these disadvantages against the clinical necessity to ensure the safest and most appropriate course of treatment.

Frequently Asked Questions

The main disadvantages include common local complications such as infection, phlebitis (vein inflammation), and infiltration, along with more serious systemic risks like air embolism, fluid overload, and allergic reactions. Infusions can also cause patient discomfort, limit mobility, and lead to long-term vein damage with frequent use.

Not necessarily. While IV therapy offers faster and 100% absorption, studies show that for many severe infections, oral antibiotics are equally effective for stable patients and are often preferred due to lower cost, greater convenience, and avoidance of the risks associated with an invasive IV procedure.

Yes, IV therapy can potentially cause blood clots. Phlebitis, or inflammation of the vein, can sometimes lead to thrombophlebitis, which involves clot formation. Prolonged use of an IV catheter is also a risk factor for deep vein thrombosis (DVT) in some cases.

Infiltration is the leakage of non-irritating IV fluids into surrounding tissue, while extravasation is the leakage of an irritating or vesicant substance. Extravasation is more serious and can cause significant tissue damage, blistering, and necrosis.

Yes, some patients experience anxiety or fear related to needles (trypanophobia). The procedure can also be psychologically burdensome, especially for those facing long-term treatment, due to restricted mobility and the reminder of their health issues.

Frequent or prolonged IV therapy can cause permanent vein damage and scarring, a condition sometimes called 'venous depletion.' This can make future IV access more difficult and painful. Long-term use of certain medications, like high-dose vitamins, can also strain organs like the kidneys and liver.

To minimize risks, always receive IV therapy from trained healthcare professionals in a sterile environment. Ensure they follow proper procedures and disclose any allergies or pre-existing conditions. Monitor the insertion site for signs of complication like pain, redness, or swelling, and immediately report any concerning symptoms to your care team.