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Tsitsi Maria Kirk Jepsen1, Pernille Ravn2

  • 1Fælles Medicinske Afdelinger, Syddansk Universitetshospital - Esbjerg Sygehus.

Ugeskrift for Laeger
|November 12, 2024
PubMed
Summary

Alternate-day oral iron supplements improve treatment for premenopausal women with anemia. Lower daily or alternate-day doses (60-80 mg) are better tolerated and as effective as higher twice-daily doses for improving iron levels.

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Area of Science:

  • Reproductive Health
  • Hematology
  • Pharmacology

Background:

  • Iron deficiency anemia is common in premenopausal women, impacting their quality of life.
  • Standard daily oral iron supplements often cause gastrointestinal side effects.
  • Alternative dosing regimens may improve treatment tolerability and adherence.

Purpose of the Study:

  • To compare the efficacy and tolerability of different oral iron dosing strengths and frequencies.
  • To evaluate optimal iron supplementation strategies for premenopausal women with anemia.

Main Methods:

  • Systematic review of clinical trials comparing various oral iron dosing regimens.
  • Analysis of studies examining ferritin and hemoglobin levels.
  • Assessment of patient-reported gastrointestinal side effects.

Main Results:

  • Twice-daily 160 mg elemental iron significantly increased ferritin but not hemoglobin levels and showed poor tolerance.
  • Lower doses of 60-80 mg elemental iron taken daily or every other day were better tolerated.
  • Lower dose regimens demonstrated comparable or better efficacy in mild to moderate anemia.

Conclusions:

  • Alternate-day or daily low-dose oral iron (60-80 mg) is a more tolerable and effective strategy for mild to moderate anemia in premenopausal women.
  • Higher doses (160 mg twice daily) are poorly tolerated and offer no significant hemoglobin improvement.
  • Further research is needed for severe anemia treatment strategies.

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