We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Iron supplementation
From WikEM
Contents
Background
There are multiple types of oral and intravenous therapy. IV therapy is usually reserved for patients undergoing epoetin therapy or severely anemic Jehovah's Witness patients and should be cautiously administered due to the risk of anaphylaxis with some preparations.[1]
Oral Preparations
Recommended oral daily dose for the treatment of iron deficiency in adults is in the range of 150 to 200mg/day of elemental iron
- Ferrous Sulfate
- Ferrous fumarate
- Ferrous gluconate
- Ferrous succinate
Elemental Iron Percentages
| Iron Preparation | % of Elemental Iron |
| Ferrous Fumarate | 33% |
| Ferrous Sulfate | 20% |
| Ferrous Gluconate | 12% |
| Ferric pyrophosphate | 30% |
| Ferroglycine sulfate | 16% |
| Ferrous carbonate (anhydrous) | 38% |
Intravenous Preparations
Occasionally used by nephrologists and patients receiving epoitin. IV iron can increase hemoglobin concentrations by 1-2 g/dL
- Iron dextran
- Iron dextrin
- Iron sodium gluconate
- Iron hyroxysaccharate
IV iron Regimens
Low dose
- 20–60mg every dialysis session[1]
- Hemodialysis patients only
- Any of iron preparations suitable
- May be given as IV push
Medium dose
- 100–400mg as IV infusion
- All iron preparations (maximum dose of iron sodium gluconate is 62.5–125mg)
High dose
- 500–1000mg
- Must be given as IV infusion
- Only iron dextran suitable
- Only for patients with large iron deficit and resistance to all other treatment regemins
Intramuscular preparations
Rarely if ever used
- Iron sorbitol citrate is only possible formulation
See Also
References
- ↑ 1.0 1.1 Macdougall IC. Strategies for iron supplementation: oral versus intravenous. Kidney Int Suppl. 1999;69:S61-S66.
