stores.1-3 Patients should be provided with information brochures about the iron therapy prescribed. Diet Increase in dietary iron may be valuable for secondary prevention of iron deficiency1 but should not be relied upon as treatment. Consider referral to an Accredited Practising Dietician. Oral therapy Oral iron therapy is suitable and effective as first line therapy in most patients with iron deficiency or iron deficiency anaemia.1 When given at equivalent elemental iron doses, different oral iron salts have similar efficacy and tolerability.1 Intramuscular therapy Intramuscular (IM) iron is effective but painful and may be associated with permanent skin staining. It is no trial than IV infusion.1 Its use is discouraged.1,2 Intravenous therapy Three preparations of intravenous iron (IV) are approved for IV use in Australia: Ferric carboxymaltose: Iron polymaltose: Iron sucrose: See Appendix 2 for indications and comparison information. Making the choice Oral iron therapy is suitable and effective as first line therapy in most patients, including most obstetric patients,4,5 with iron deficiency or iron deficiency anaemia.1 Indications for intravenous iron include:1,3,5,6 contraindications to oral iron, or compliance or tolerance (side effect) issues pregnancy (beyond the first trimester) and postpartum if oral iron not suitable or effective, or to prevent physiological decompensation comorbidities which may impact on absorption (eg. intestinal mucosal disorders), or bone marrow response chronic impairment receiving erythropoiesis-stimulating agent therapy ongoing iron losses that exceed absorptive capacity requirement for iron repletion (eg. prevention of physiological decompensation or preoperatively for non-deferrable surgery) Although the initial rise in haemoglobin (Hb) is more rapid with parenteral iron, the rise in Hb at 12 weeks is similar to that observed during oral iron therapy.3 Availability of IV preparations, dosing schedules and facilities for administration are also important considerations.
stores.1-3 Patients should be provided with information brochures about the iron therapy prescribed. Diet Increase in dietary iron may be valuable for secondary prevention of iron deficiency1 but should not be relied upon as treatment. Consider referral to an Accredited Practising Dietician. Oral therapy Oral iron therapy is suitable and effective as first line therapy in most patients with iron deficiency or iron deficiency anaemia.1 When given at equivalent elemental iron doses, different oral iron salts have similar efficacy and tolerability.1 Intramuscular therapy Intramuscular (IM) iron is effective but painful and may be associated with permanent skin staining. It is no than IV infusion.1 Its use is discouraged.1,2 Intravenous therapy Three preparations of intravenous iron (IV) are approved for IV use in Australia: Ferric carboxymaltose: Iron polymaltose: Iron sucrose: See Appendix 2 for indications and comparison information. Making the choice Oral iron therapy is suitable and effective as first line therapy in most patients, including most obstetric patients,4,5 with iron deficiency or iron deficiency anaemia.1 Indications for intravenous iron include:1,3,5,6 contraindications to oral iron, or compliance or tolerance (side effect) issues pregnancy (beyond the first trimester) and postpartum if oral iron not suitable or effective, or to prevent physiological decompensation comorbidities which may impact on absorption (eg. intestinal mucosal disorders), or bone marrow response chronic impairment receiving erythropoiesis-stimulating agent therapy ongoing iron losses that exceed absorptive capacity requirement for iron repletion (eg. prevention of physiological decompensation or preoperatively for non-deferrable surgery) Although the initial rise in haemoglobin (Hb) is more rapid with parenteral iron, the rise in Hb at 12 weeks is similar to that observed during oral iron therapy.3 Availability of IV preparations, dosing schedules and facilities for administration are also important considerations. trial
iron-product-choice-and-dose-calculation-adults-20052016.docx