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Liposomal Iron vs. Conventional Iron in the Treatment of Iron Deficiency Anemia in Children: A Randomized Controlled

Suresh Rangaraj1, Preethi Suresh1, Subash Sundar1

  • 1Department of Pediatrics, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, IND.

Cureus
|December 23, 2025
PubMed

Insights

Ferrous ascorbate improved hemoglobin levels more effectively than liposomal iron in children with iron deficiency anemia (IDA). However, liposomal iron demonstrated better oral tolerance and adherence, despite lower efficacy.

Area of Science:

  • Pediatrics
  • Hematology
  • Pharmacology

Background:

  • Gastrointestinal side effects of conventional ferrous iron impact treatment adherence for iron deficiency anemia (IDA).
  • Liposomal iron offers improved bioavailability and tolerability, addressing limitations of standard iron supplementation.
  • A comparative study is needed to evaluate liposomal iron against ferrous ascorbate in pediatric IDA.

Purpose of the Study:

  • To compare the efficacy and tolerability of liposomal iron versus ferrous ascorbate in treating IDA in children aged 6-60 months.
  • To assess improvements in hemoglobin levels and iron indices between the two treatment groups.
  • To evaluate oral tolerance, adherence, and incidence of constipation with each iron formulation.

Main Methods:

  • A randomized study involving 98 children (6-60 months) with confirmed IDA.
  • Group A received liposomal iron (1 mg/kg/day); Group B received ferrous ascorbate (3 mg/kg/day) for one month.
  • Hemoglobin levels, iron indices, oral tolerance, adherence, and constipation were assessed.

Main Results:

  • Ferrous ascorbate significantly increased hemoglobin levels compared to liposomal iron (p=0.0018).
  • Liposomal iron showed better oral tolerance (p=0.042), adherence (p=0.047), and less constipation (p=0.046).
  • Baseline characteristics and hemoglobin levels were similar in both groups before treatment.

Conclusions:

  • Ferrous ascorbate was more effective in raising hemoglobin levels in pediatric IDA despite tolerability issues.
  • Liposomal iron offered superior tolerability and adherence but was less effective in improving hemoglobin.
  • The choice of iron formulation for IDA in children requires balancing efficacy with patient tolerance and adherence.
Abstract

Keywords:
conventional ironelemental ironferrous ascorbateiron deficiency anemialiposomal iron

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