Anemia - Resources

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The hematocrit should return to normal after 2 months of iron therapy. However, iron supplementation should be continued for another 6 - 12 months to replenish the body's iron stores in the bone marrow.

Intravenous or Injected Iron

In some cases, iron is administered through muscular injections or intravenously. Intravenous iron has the advantage of causing less gastrointestinal discomfort and inconvenience. It may be in the form of iron dextran (Dexferrum, InFed), sodium ferric gluconate complex in sucrose (Ferrlecit), or iron sucrose (Venofer). Ferrlecit or Venofer are equally effective and generally safer than iron dextran.

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Candidates. The injected or intravenous forms should be limited to the following patients with iron deficiency:

• People with iron deficiency anemia in whom oral therapy has clearly failed.
• Patients with bleeding disorders in which blood loss continues to exceed the rate at which oral iron is absorbed.
• In emergencies, when people need red blood cells but transfusion is not appropriate or available.
• In people with serious gastrointestinal disorders, such as inflammatory bowel disease, who cannot take iron therapy by mouth.
• People undergoing hemodialysis who receive supplemental erythropoietin therapy. Sodium ferric gluconate complex in sucrose (Ferrlecit) or iron sucrose (Venofer) is specifically approved as first-line therapy for these patients.

Certain patients, even if they meet these qualifications, may not be appropriate candidates or should be monitored closely for complications. They include:

• Patients with any underlying autoimmune disease.
• Malnourished patients who also have an underlying infection.
• Patients who are at risk for iron overload.

Side Effects. Some side effects differ depending on how the iron is administered and include the following:

• Muscular injections include pain at the site.
• Intravenous administration can cause pain in the vein, flushing, and metallic taste, all of which are brief.

For both methods, side effects and serious complications can include: