Iron deficiency anaemia is one of the largest problem during pregnancy in a country like India. So here is a short presentation on iron therapy which we are currently prescribing to our patients.

2. Indications of iron therapy :
- Iron deficiency anaemia
-Pregnancy
-Infancy
Routs of iron therapy
1. Oral route
2. Parenteral route

3. • Iron is best absorbed in ferrous form within the body.
• Preparations available are
 Ferrous gluconate
 Ferrous fumarate
 Ferrous succinate
 Tab. Fersolate
- Contains 60 mg of elemental iron, trace of copper &
manganese.
- Doses : 1tab. thrice a day, before meal.
If larger dose is necessary then maximum
6 tab./day can be given.
- Treatment should be continued till the blood picture
becomes normal ; There after a maintenance dose of 1
tab./day is to be continued for atleast 100 days following
delivery to replenish the iron stores.

4.  Drawbacks of oral iron therapy :
 Intolerance : It is evidenced by
- Pain - Nausea
- Vomiting - Diarrhoea
- Constipation
• To avoid intolerance, therapy should be started with
a smaller dose (1 tab./day) and then to increase the
dose to a maximum of 3 tab./day
 Unpredictable absorption rate : Various factors are
involved in the iron absorption & it’s utilization
Reduce Absorption Increase Absorption
Antacids Ascorbic acid
Phosphates Lactate
Oxalates Amino acids

5.  With the therapeutic dose, the serum iron may
be restored but there is difficulty in replenishing
the iron stores.
 Response : It is evidenced by
- Sense of well being
- Increased appetite
- Improved outlook of the patient
- Rise in Hb levels about 0.7 gm/100 ml/week.
 Contraindications :
- Intolerance to oral iron
- Severe anaemia in advance pregnancy

6.  Indications :
- Intolerence to oral iron
- Cases seen for the first time during the last 8-10
weeks with severe anemia.
 Routes
1. Intravenous route
2. Intramuscular route
1. Intravenous route:
a. Total dose infusion (TDI)
b. Repeted injections

7. a. Total dose infusion (TDI) :
- Iron dextran or Iron sucrose are used to correct the
deficit in a single sitting.
- Estimation of dose :
• For Iron dextran
0.3 x W(100-Hb%) (W= weight of the pt. in pounds)
• For Iron sucrose : polynuclear ferric hydroxide
Dose = 2.3 x W x D + 500 (W= weight in kg before pregnancy)
D= Hb ( target-actual )
• Pre-requisites:
- Correct diagnosis of iron deficiency anaemia
- Adequate supervision
- Facilities for management of anaphylactic reaction
• Advantages :
- It eliminates repeated and painful I.M inj.
- Early discharge of the patients
- Less costly as compared to I.M therapy

8. 2. Intramuscular Route
- Compounds are used:
. Iron dextran (Imferon)
. Iron sorbitol complex – Jectofer
- Both preparation contains 50 mg of
elemental iron in 1 ml.
• Precautions :
- Oral iron should be suspended atleast 24
hrs prior to therapy to avoid reaction.
• Drawbacks :
- Painful procedure
- Chance of abscess formation at the site of infection
- Discoloration of the skin over the injection site