title: [Importance of the different i.v. iron generations for everyday medical practice].
abstract: BACKGROUND
  Iron deficiency and anaemia occur in particular in women or as comorbid conditions to a varietyof chronic diseases. Besides oral preparations, parenteral iron therapies are also available for the treatment of iron deficiency or anaemia. In the light of the growing importance and increasing number of parenteral iron preparations, theirpharmacology and application as well as the chronology of their approvals and thecharacteristicsof the various preparations are presented herefor comparison.
  
  
  METHODS
  Review.
  
  
  RESULTS
  To date, there are three different generations of parenteral iron preparations, which differ in terms of stability, safety and dosage. In particular, the active substances of the third generation, ferric carboxymaltose, iron isomaltoside and ferumoxytol are characterised by high complex stability and comparable safety, also allowing rapid application of high doses of iron.
  
  
  CONCLUSIONS
  High molecular weight iron dextran, as a representative of 1st generation iron preparations, should no longer be used if possible, as more recent i.v. iron preparations are available with considerably lower risk of serious anaphylactic reactions. Ferrous gluconate and iron sucrose, as representatives of the 2nd generation, are very efficient preparations, but they require frequent visits to the clinic or the doctor, as they may only be administered in low doses because of labile iron complexes. The three 3rd generation parenteral iron formulations have advantages in handling in everyday practice, since they offer comparably good safety profiles, high complex stability and thus the possibility of rapid application of high doses of iron up to the total cumulative dose. Furthermore, test doses are not required with these preparations, which also simplifies their use.
authors.affiliation: Medizinische Klinik III (Nephrologie), Klinikum Coburg GmbH, Coburg. patrick.biggar@klinikum-coburg.de
authors.forename: P
authors.initials: P
authors.lastname: Biggar
authors.forename: K-M
authors.initials: KM
authors.lastname: Hahn
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D004187:Disaccharides / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D057915:Drug Substitution; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D000077605:Ferric Oxide, Saccharated; D052203:Ferrosoferric Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D005937:Glucaric Acid / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D007505:Iron-Dextran Complex / Q000008:administration & dosage / Q000009:adverse effects; D008320:Maltose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013329:Structure-Activity Relationship; D016896:Treatment Outcome
chemical_list: D004187:Disaccharides; D005290:Ferric Compounds; C557707:iron isomaltoside 1000; C522335:ferric carboxymaltose; D008320:Maltose; D007505:Iron-Dextran Complex; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; C035552:ferric gluconate; D052203:Ferrosoferric Oxide