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Intravenous Iron Therapy: A Summary of Treatment Options and Review of Guidelines

Department of Pharmacy Services, Huntsman Cancer Hospital, University of Utah Hospitals and Clinics, Salt Lake City, Utah, scott.silverstein{at}hci.utah.edu

Jeffrey A. Gilreath, PharmD

Department of Pharmacy Services, Huntsman Cancer Hospital, University of Utah Hospitals and Clinics, Salt Lake City, Utah

George M. Rodgers, MD, PhD

Departments of Medicine and Pathology, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah

Iron replacement for iron-deficiency anemia has historically been accomplished with the use of oral iron therapy. Although oral iron is appropriate for most iron-deficiency anemia patients, many patients do not respond to or may be intolerant of oral iron, or may experience bleeding of sufficient magnitude to require higher iron doses than that achievable with oral iron. Intravenous iron therapy is a useful option for these latter patients. Three intravenous iron products are recommended: low-molecular weight iron dextran (INFeD), ferric gluconate (Ferrlecit), and iron sucrose (Venofer). These intravenous iron products have superior safety profiles compared to high-molecular weight iron dextran. The Food and Drug Administration's approval of erythropoietic-stimulating agents to treat certain types of anemia has increased usage of intravenous iron for functional iron deficiency. This review summarizes the current status of intravenous iron products and discusses their advantages and disadvantages in treating both absolute and functional iron deficiency.

Key Words: iron dextran • ferric gluconate • iron sucrose • functional iron deficiency • erythropoietic-stimulating agent

This version was published on December 1, 2008

Journal of Pharmacy Practice, Vol. 21, No. 6, 431-443 (2008)
DOI: 10.1177/0897190008318916


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