Iron supplements on alternative days may be as effective as daily with fewer adverse effects

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Iron supplements on alternative days may be as effective as daily with fewer adverse effects

Many patients find it difficult to take oral forms of iron due to GI adverse effects. This study gave single doses of 60 mg iron on consecutive days versus the same dose on alternate days.1 The participants were described as women who were iron depleted and were followed for 14 days.

The outcomes measured in fractional iron absorptions were 16·3% (9·3, 28·8) in the consecutive-day group versus 21·8% (13·7, 34·6) in the alternate-day group (p=0·0013). Eight (38%) of 21 patients in the consecutive-day group and five (26%) of 19 in the alternate-day group reported gastrointestinal adverse events (all were grades 1–2; grade 4 is the most severe), and that number would probably have increased if constipation had also been recorded.

Unanswered questions are: will this apply to people with more severe anaemia and will alternate day dosing lead to significantly decreased adherence.

Reference:

  1. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials.Lancet Haematology 2017.  Click here 

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.