Iron deficiency anaemia 2

Parenteral iron therapy is usually not required if oral iron is increased gradually from a low starting dose, and if ongoing iron losses (e.g. blood loss) are addressed.1 Oral iron is first-line therapy for most people with iron deficiency anaemia but the dose and duration must be adequate.

The indications for parenteral iron therapy include intolerance of oral iron (e.g. gastrointestinal adverse effects), or poor adherence to, or lack of, efficacy of oral iron (despite changing the dose or frequency), malabsorption (e.g. coeliac disease) or high iron need (e.g. haemodialysis, ongoing blood loss).2,3 

If parenteral iron therapy is necessary, the intravenous route is preferred because intramuscular iron is painful, stains skin and is poorly absorbed.1,3 Parenteral iron therapy is used in two ways:

1. To give the total amount of iron required (as iron polymaltose) in a single dose to correct the haemoglobin deficit and provide at