Intravenous iron: an update

Abstract

Iron deficiency is the most common nutritional deficiency worldwide, with significant adverse health consequences in the presence or absence of anaemia. Total dose intravenous iron replacement is recommended for replacement of iron in patients with severe iron deficiency, especially in the presence of anaemia, intolerance or inefficacy following oral iron, or states of inflammation where upregulation of hepcidin may impair gastrointestinal absorption of iron. Currently, available intravenous iron formulations have been demonstrated to have an excellent overall safety profile, but potential adverse effects, including skin staining, infusion‐related reactions and hypophosphataemia, have been described. Knowledge of differences in administration and safety profiles of currently available iron formulations will allow appropriate prescription, counselling, as well as recognition and management of adverse events in patients requiring intravenous iron.

Parenteral iron therapy in children with iron deficiency anemia

“…Oral iron therapy with standard ferric salts is by far the lowest cost option and is readily available, but often of limited efficacy, with frequent gastrointestinal side effects and poor adherence. Conversely, intravenous iron formulations are associated with significant cost, yet have been previously shown to replenish hemoglobin levels more effectively than oral iron[ 33 , 34 ]. Older-generation intravenous iron products have lower prices than newer-generation products.…”