3 November 2010

Iron deficiency anaemia affects people of all ages, but young women, pregnant women and children are at increased risk. There are more than 100 oral iron replacement products available on the market, however only a few contain enough iron to treat iron deficiency anaemia.

The latest NPS News discusses causes, investigation and treatment options for iron deficiency anaemia based on dose and duration, to help health professionals manage anaemia and potential side effects and drug interactions.

“Establishing the cause of iron deficiency anaemia is essential to rule out serious disease like gastric or colon cancer, to ensure the right therapy is prescribed and to prevent further iron imbalance,” NPS clinical adviser, Danielle Stowasser said.  

Likely causes of iron deficiency anaemia vary according to age, co-morbidities and medicines use. Causes may be physiologic (e.g. increased iron demand due to pregnancy) or pathologic (e.g. increased iron loss because of bleeding, decreased iron absorption because of coeliac disease).

Low serum ferritin—not low serum iron—is the most useful marker of early iron deficiency. Serum ferritin most accurately reflects the body's iron stores and a low level can be seen before serum iron is affected. However, interpreting iron studies can be complex and expert advice may be needed.

“While oral iron is first line therapy for most people with iron deficiency anaemia, it is critical that the dose and duration are adequate,” Dr Stowasser said.

There are more than 100 oral preparations containing iron available over the counter in Australia but few contain enough iron to treat iron deficiency anaemia, as shown in the latest NPS News.

Doses also differ for adults and children, and parents should be reminded that small children can overdose on even a small amount of an iron preparation.

If oral iron causes stomach upset, it can be taken with or shortly after food. Other ways to minimise stomach upset are to start on a low dose and gradually increase as tolerated (e.g. start with alternate daily dosing then increase to daily or twice daily dosing) or to give smaller, more frequent doses (e.g. use oral liquid in divided doses).

For more information about iron deficiency anaemia visit www.nps.org.au/health_professionals/publications/nps_news/current/iron_anaemia

ENDS

Independent, evidence-based and not-for-profit, NPS enables better decisions about medicines and medical tests.We are funded by the Australian Government Department of Health and Ageing.