Iron supplementation: Difference between revisions
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==Background== | ==Background== | ||
*Multiple types of oral and intravenous therapy available | |||
*IV therapy is usually reserved for patients undergoing epoetin therapy or severely anemic [[Jehovah's Witness patients]] | |||
**Should be cautiously administered due to the risk of [[anaphylaxis]] with some preparations.<ref name="Macdougall">Macdougall IC. Strategies for iron supplementation: oral versus intravenous. Kidney Int Suppl. 1999;69:S61-S66.</ref> | |||
==Oral Preparations== | ==Oral Preparations== | ||
Recommended oral daily dose for the treatment of iron deficiency in adults is in the range of 150 to | 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 Sulfate | ||
*Ferrous fumarate | *Ferrous fumarate | ||
| Line 19: | Line 21: | ||
===IV iron Regimens=== | ===IV iron Regimens=== | ||
====Low dose==== | ====Low dose==== | ||
* | *20–60mg every dialysis session<ref name="Macdougall"></ref> | ||
*Hemodialysis patients only | *Hemodialysis patients only | ||
*Any of iron preparations suitable | *Any of iron preparations suitable | ||
*May be given as IV push | *May be given as IV push | ||
====Medium dose==== | ====Medium dose==== | ||
* | *100–400mg as IV infusion | ||
*All iron preparations (maximum dose of iron sodium gluconate is 62.5–125mg) | *All iron preparations (maximum dose of iron sodium gluconate is 62.5–125mg) | ||
====High dose==== | ====High dose==== | ||
* | *500–1000mg | ||
*Must be given as IV infusion | *Must be given as IV infusion | ||
*Only iron dextran suitable | *Only iron dextran suitable | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:FEN]] | |||
Latest revision as of 16:17, 29 September 2019
Background
- Multiple types of oral and intravenous therapy available
- IV therapy is usually reserved for patients undergoing epoetin therapy or severely anemic Jehovah's Witness patients
- 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
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