Iron supplementation

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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

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


  1. 1.0 1.1 Macdougall IC. Strategies for iron supplementation: oral versus intravenous. Kidney Int Suppl. 1999;69:S61-S66.