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Medications for Anemia and Nutritional Treatments

Medications for Anemia & Nutritional Treatments

Introduction

Anemia is a common nutritional deficiency disorder and affects up to one-third of the world’s population. This article provides possible medications used for the treatment of anemia.

Anemia is defined as a decrease in the number of red blood cells or hemoglobin in the blood. It is a common nutritional deficiency disorder and a global public health problem that affects both developing and developed countries.

This condition affects up to one-third of the global population, but in many cases, it is mild and asymptomatic and does not require management.

This article will discuss briefly the possible treatment and available medications for anemia.

Medications for Anemia and Possible Treatments

The initial treatment is determined by the cause, laboratory test results, and clinical symptoms.

Routine screening is the most common method of detecting anemia.

A complete blood cell count, reticulocyte count, peripheral smear, and mean corpuscular volume should be performed as well.

Diet should be evaluated, and nutritional counseling should be provided.

  1. Anemia due to acute blood loss

If you have anemia due to blood loss, your physician may suggest IV fluids, crossmatched packed red blood cells, and oxygen.

Your physician target is to maintain hemoglobin levels above 7 g/dL. If you are suffering from cardiovascular disease, you will require a higher hemoglobin target of more than 8 g/dL.

  1. Anemia due to nutritional deficiencies

If you have nutritional deficiencies causing anemia, your physician may suggest an oral/IV iron, B12, and folate. 

Oral iron supplementation is by far the most common method of iron repletion.

The amount of iron given to you is determined by your age, calculated iron deficit, rate of correction required, and your ability to tolerate side effects.

Your hemoglobin levels usually return to normal in 6-8 weeks, with an increase in reticulocyte count occurring in just 7-10 days.

If you need a rapid increase in iron levels, IV iron may be beneficial and this is up to your doctor’s decision.

  1. Anemia due to defects in the bone marrow and stem cells

Conditions such as aplastic anemia require bone marrow transplantation.

  1. Anemia of Chronic Disease

Anemia in the setting of renal failure, responds to erythropoietin.

Anemia of chronic disease that is caused by autoimmune and rheumatological conditions requires treatment of the underlying disease.

  1. Anemia due to increased red blood cell destruction

Hemolytic anemia caused by faulty mechanical valves will need replacement.

Hemolytic anemia due to medications requires the removal of the offending drug.

Persistent hemolytic anemia requires splenectomy.

To reduce the incidence of sickling in hemoglobinopathies such as sickle anemia, blood transfusions, exchange transfusions, and even hydroxyurea are used.

The uncontrolled coagulation and thrombosis of DIC require the removal of the offending stimulus.

Antifibrinolytic agents are required for patients with life-threatening bleeding.

Medications for anemia due to iron deficiency

Patients who have an underlying condition that causes iron deficiency anemia should be treated or referred to a subspecialist (e.g., gynecologist, gastroenterologist) for definitive care.

Oral Iron Therapy

Adults require 120 mg of elemental iron per day for three months to treat iron deficiency anemia; children require 3 mg per kg per day, up to 60 mg per day.

After one month of treatment, an increase in hemoglobin of 1 g per dL indicates an adequate response to treatment and confirms the diagnosis.

Adults should continue therapy for three months after anemia has been corrected to allow iron stores to replenish.

Medications for anemia due to iron deficiency

Algorithm for treatment of iron deficiency anemia

Parenteral therapy

Patients who cannot tolerate or absorb oral preparations, such as those who have had a gastrectomy, gastrojejunostomy, bariatric surgery, or other small bowel surgery, may benefit from parenteral therapy.

The most common indication for intravenous therapy is GI effects, worsening inflammatory bowel disease symptoms, unresolved bleeding, renal failure–induced anemia treated with erythropoietin, and insufficient absorption in celiac disease patients.

The following table illustrates the current formulations used to treat iron deficiency anemia

Form Formulation Elemental Iron Adult Dosage

Intravenous

Sodium ferric gluconate (Ferrlecit)

Solution for injection

12.5 mg per mL

 

 

Based on weight and amount of desired change in hemoglobin*

Iron dextran

Solution for injection

50 mg per mL

Iron sucrose

Solution for injection

20 mg per mL

Ferumoxytol

Solution for injection

30 mg per mL

Oral

Ferrous fumarate

324-mg tablet

106 mg

One tablet twice per day

Ferrous gluconate

300-mg tablet

38 mg

One to three tablets two or three times per day

Ferrous sulfate

325-mg tablet

65 mg

One tablet three times per day

Nutritional Treatment of Anemia

The amount of food we eat that aids in hemoglobin synthesis is important in treating anemia. In general, foods high in iron, copper, zinc, folic acid, Vitamin B-12, and protein should be focused on in the treatment of anemia. The combination of iron and B-vitamins is particularly good for anemia treatment.

  1. Vitamin B12

Pernicious anemia can be caused by low vitamin B12. Vitamin B12 supplements are frequently used to treat this type of anemia.

Breakfast cereals with added vitamin B12 are good sources of vitamin B12. Meats like beef, liver, fish, and poultry; Foods fortified with vitamin B12, such as soy-based beverages and vegetarian burgers, Eggs, and dairy products (such as milk, yogurt, and cheese).

  1. Folic Acid

Folic acid (folate) is a type of B vitamin found in foods. To make and maintain new cells, your body needs folic acid.

Also, for pregnant women, folic acid is very important. It helps them prevent anemia and encourages healthy fetal growth.

Bread, rice with added folic acid, spinach, and other dark green leafy plants, black-eyed peas, and dried beans, beef, eggs, bananas, oranges, and other fruit and juices are good sources of folic acid.

  1. Vitamin C

Vitamin C aids iron absorption in the body.

Vegetables and fruits, particularly citrus fruits, are high in vitamin C. Citrus fruits such as oranges, grapefruits, tangerines, and similar fruits.

Fresh and frozen fruits, vegetables, and juices typically contain more vitamin C than canned fruits, vegetables, and juices.

Kiwi fruit, strawberries, and cantaloupes are also high in vitamin C.

Broccoli, peppers, Brussels sprouts, tomatoes, cabbage, potatoes, and leafy green vegetables like turnip greens and spinach are high in vitamin C.

  1. Honey

Honey is a potent source of iron, copper, and manganese. When these elements are combined, they aid in hemoglobin synthesis. Honey is, therefore, a powerful weapon against anemia.

  1. Legumes and Nuts

Legumes and nuts such as pulses, almonds, whole grain cereals, dry dates, peanuts, and walnuts are effective against the symptoms and causes of anemia.

Conclusion

The initial treatment of anemia is determined by the cause, laboratory test results, and clinical symptoms.

Routine screening is the primary method of detecting anemia.

A complete blood cell count, reticulocyte count, peripheral smear, and mean corpuscular volume should be performed as well.

Always remember to eat foods rich in iron, copper, zinc, folic acid, Vitamin B-12, and protein.

If you suspect that you might be anemic consult your doctor immediately.

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References

  1. SM;, C. (2005). Anemia: Diagnosis and management. Journal of pediatric health care: official publication of National Association of Pediatric Nurse Associates & Practitioners. PubMed
  2. Short, M. W., & Domagalski, J. E. (2013, January 15). Iron deficiency anemia: Evaluation and management. American Family Physician. American Academy of Family Physicians 
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