From the Guidelines
The recommended treatment for iron deficiency anemia is intravenous iron supplementation, as it has been shown to be more effective and better tolerated than oral iron in patients with inflammatory bowel disease, and should be considered as first-line therapy for patients with a hemoglobin level <10 g/dL 1.
Treatment Approach
When treating iron deficiency anemia, it is essential to address the underlying cause of the deficiency, whether it's blood loss, poor dietary intake, or malabsorption.
- The treatment should focus on correcting the anemia and replenishing iron stores.
- Intravenous iron formulations like iron sucrose or ferric carboxymaltose may be used, especially in patients who cannot tolerate oral iron or have a hemoglobin level <10 g/dL.
- Oral iron supplementation, typically with ferrous sulfate, may be considered in carefully selected patients with mild anemia and clinically inactive disease.
Monitoring and Follow-up
- Treatment success should be monitored with hemoglobin checks after 4-8 weeks and iron studies after 3 months.
- Serum ferritin levels should be monitored to avoid toxicity of iron overload, especially in children and adolescents, and should not exceed 500 mg/L 1.
Additional Considerations
- Dietary counseling to increase iron-rich foods (red meat, beans, leafy greens) is an important adjunct to supplementation.
- Patients should be advised about common side effects of iron supplementation, including constipation, black stools, and gastrointestinal discomfort.
- Starting with a lower dose and gradually increasing can improve tolerance to oral iron supplementation 1.
From the FDA Drug Label
16 HOW SUPPLIED Ferrous Sulfate Tablets are available as follows: Each tablet contains 324mg of ferrous sulfate, equivalent to 65mg of elemental iron, providing 362% of the U.S. recommended daily intake (RDI) of iron for adults and children 4 and older.
The recommended treatment for a patient with iron deficiency anemia is ferrous sulfate. The patient can take 65mg of elemental iron per tablet, which is equivalent to 324mg of ferrous sulfate, as indicated in the drug label 2.
From the Research
Iron Deficiency Anemia Treatment
The recommended treatment for a patient with iron deficiency anemia depends on several factors, including the presence of inflammation, the time available for iron replenishment, and the anticipated risk of side-effects or intolerance 3.
- Intravenous Iron Preparations: Intravenous iron preparations are indicated for the treatment of iron deficiency when oral preparations are ineffective or cannot be used 3.
- Dosing Considerations: A total cumulative dose of 1000 mg of IV iron may be insufficient for iron repletion in a majority of patients with IDA, and a dose of 1500 mg is closer to the actual iron deficit in these patients 4.
- Oral Iron Supplementation: Daily or intermittent iron supplementation can increase hemoglobin levels and reduce the risk of anaemia and iron deficiency in various populations, including infants, preschool and school-aged children, and pregnant and non-pregnant women 5.
- Vitamin C or Ascorbate Co-intervention: The treatment efficacy of oral vitamin C or ascorbate given as co-intervention with iron for anemia is not statistically significant, and the methodological quality of evidence of these effect measures is very low 6.
- Diagnosis, Treatment, and Prevention: The diagnosis, management, and treatment of patients with iron deficiency and iron deficiency anemia change depending on age and gender and during pregnancy, and a specific set of recommendations on this topic has been formulated 7.
Key Considerations
- The presence of inflammation, the time available for iron replenishment, and the anticipated risk of side-effects or intolerance should be considered when selecting a treatment for iron deficiency anemia 3.
- The choice of treatment should be based on the individual patient's needs and circumstances, and may involve a combination of oral and intravenous iron preparations, as well as other interventions such as vitamin C or ascorbate co-intervention 3, 4, 5, 6.