title: Single-dose intravenous iron for iron deficiency: a new paradigm.
abstract: Iron-deficiency anemia is the most common hematologic problem in the world. Although oral iron is often viewed as front-line therapy, extensive published evidence has accumulated that IV iron is superior, in both efficacy and safety, to oral iron in many clinical situations and should be introduced much sooner in the treatment paradigm of iron-deficient patients. In this chapter, we will review the formulations of IV iron that allow total complete replacement doses in 1 or 2 sessions including practical tips for administration. We realize safety concerns abound and therefore will analyze evidence based overstated concerns regarding serious adverse events highlighting unnecessary interventions for minor, self-limiting infusion reactions, which infrequently occur with intravenous iron administration. Recent data for the use of IV iron in a variety of clinic situations will be reviewed including women with heavy uterine bleeding, pregnancy, bariatric surgery, inflammatory bowel disease, and restless legs syndrome. Briefly discussed is the new frontier of IV iron's use in the prevention of acute (high altitude) mountain sickness. It is clear that in many clinical situations IV iron is a new and improved standard of care offering advantages over oral iron in efficacy, toxicity, and convenience to patients and health care providers.
authors.affiliation: Private Practice, Baltimore, MD.|Clinical Professor of Medicine, Georgetown University School of Medicine, Washington, DC; and.
authors.forename: Michael
authors.initials: M
authors.lastname: Auerbach
authors.affiliation: Department of Hematology and Medical Oncology, Division of Laboratory Medicine, and.|Department of Pathology, Oregon Health Sciences University, Portland, OR.
authors.forename: Thomas
authors.initials: T
authors.lastname: Deloughery
mesh_terms: D061605:Administration, Intravenous; D000532:Altitude Sickness / Q000097:blood / Q000188:drug therapy; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D050110:Bariatric Surgery; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000188:drug therapy; D007501:Iron / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy; D012148:Restless Legs Syndrome / Q000097:blood / Q000188:drug therapy; D014592:Uterine Hemorrhage / Q000097:blood / Q000188:drug therapy
chemical_list: D007501:Iron