Greater Glasgow and Clyde Medicines

Updated Guideline - Treatment of IDA

UPDATED GUIDELINE: Treatment of Iron Deficiency Anaemia: Oral and IV Iron Therapy 

An updated GGC guideline on the Treatment of Iron Deficiency Anaemia (IDA) is now available on StaffNet here.

The following changes have been made to the content:

  • Hypophosphataemia added as a caution to IV iron therapy (Ferinject® only)
  • Prescribing information for Monofer® updated for patients with body weight <50kg
  • Treatment decision tool updated to select an IV iron product which requires the least number of infusions.

An abbreviated version of this guideline is now also available in the Therapeutics Handbook here.

The main guideline is intended for use in adult patients in acute and primary care settings. The following clinical situations are not covered: pregnancy, postpartum anaemia, surgery/trauma, paediatrics (<16 years) and patients with chronic kidney disease stages 4-5.

The guideline includes information on:

  • How to diagnose IDA
  • Treatment with oral iron therapy
  • Treatment with intravenous (IV) iron therapy
  • How to monitor response to treatment.

In addition, a number of appendices are included. These provide information on two IV iron products, Ferinject® (ferric carboxymaltose) and Monofer® (iron isomaltoside 1000):

  • How to prescribe and administer by IV infusion
  • A checklist to use pre-infusion, during and post-infusion
  • A patient /relative information leaflet.

Key messages in the management of IDA:

  • Oral iron is the first line treatment of choice
  • Investigations to determine the underlying cause should be considered in parallel with treatment
  • IV iron should be reserved as a last resort.

A series of blog articles relating to this guideline are available:

Diagnosis of IDA - Iron Studies
Treatment of IDA – Oral Iron Therapy
Treatment of IDA - IV iron therapy

 

Originally published 21/01/19 and updated 07/12/2020. Medicines Update blogs are correct at the time of publication.