Suppletie van ijzer bij ijzergebreksanemie

Stand van zaken
09-10-2019
Jolien van Heek, Dorine W. Swinkels, Alexander J.M. Rennings, Kees Kramers en Hugo A.J.M. de Wit

Iron supplementation in iron deficiency anaemia

  • Iron deficiency anaemia is a common problem. The majority of patients are treated with oral iron supplements.
  • The current recommended dosage for oral supplementation of 200 mg ferrous fumarate 3x per day however, is based on a single small study of poor quality.
  • There is no consensus concerning parenteral dosing.
  • In recent years, new insights have been gained regarding both the dosage of oral supplementation and the indication for parenteral supplementation.
  • Oral therapy is preferred. In principle, 100 mg ferrous fumarate once a day is sufficient for the treatment of symptom-free patients with anaemia.
  • In cases of severe anaemia, or in patients with symptoms, 200 mg/day should be prescribed. If side effects appear, it can be dosed every other day.
  • Where oral therapy does not show effectiveness, the anaemia is severe, or rapid increase of haemoglobin is indicated, parenteral supplementation should be chosen.
  • Parenteral supplementation is more effective than oral supplementation in specific conditions, such as dialysis-dependent renal insufficiency, heart failure or active IBD.
  • Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.