Treatment

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Effective treatment should correct anaemia and replenish iron stores⁴

Oral iron is the first-line treatment for iron deficiency (ID)/iron deficiency anaemia (IDA) but may not be appropriate for all patients⁴

IV iron is indicated when there is intolerance to oral iron or an inadequate response, or rapid iron delivery is required. ID diagnosis must be based on laboratory tests⁵

If patients do not respond to oral iron therapy (i.e. an Hb increase <1 g/dL by 4 weeks) consider switching to IV iron⁴

EHA guidelines: ID/IDA treatment algorithm⁴

Reproduced from Iolascon et al. 2024.

Clinical guidelines support IV iron treatment for ID/IDA in women^4,6,7

Otherwise healthy women with ID/IDA

European Hematology Association guidelines⁴

IV iron should be considered when:

there is intolerance to oral iron or lack of compliance
there is an inadequate response to oral iron (Hb increase <1 g/dL by 4 weeks)
rapid iron delivery is required

Women with abnormal uterine bleeding

European Hematology Association guidelines⁴

IV iron treatment is recommended in women with abnormal uterine bleeding

Pregnancy

British Society for Haematology guidelines⁵

In pregnancy, IV iron should be considered:

from the second trimester onwards for women with confirmed IDA who are intolerant of, or do not to respond to, oral iron
in women who present after 34 weeks' gestation with confirmed IDA and Hb <10 g/dL

IV iron products should not be used during pregnancy unless clearly necessary. IV iron treatment should be confined to the 2nd and 3rd trimester if the benefit is judged to outweigh the potential risk to mother and the foetus.⁷

Postpartum

British Society for Haematology guidelines⁵

IV iron should be considered postpartum:

in women who are previously intolerant of, or do not respond to, oral iron
where the severity of symptoms of anaemia requires prompt management

Is it time to explore IV iron treatment for some of your ID patients?

To ensure your patients have access to IV iron treatment, refer them to an appropriate infusion centre.

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