INDIVIDUALIZED SELECTION OF ORAL AND INTRAVENOUS IRON THERAPY IN WOMEN OF REPRODUCTIVE AGE WITH IRON DEFICIENCY ANEMIA

Vollständiger Abstract

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<p>Iron deficiency anemia (IDA) is highly prevalent among women of reproductive age because menstrual blood loss, pregnancy, childbirth, dietary insufficiency, and gastrointestinal disorders may coexist. The objective of this re­view was to synthesize current evidence on the individualized selection of oral and intravenous iron preparations, with emphasis on efficacy, tolerability, speed of hematologic response, and safety. A structured narrative review of peer-reviewed randomized trials, systematic reviews, and international guidelines published mainly between 2011 and 2025 was performed. Evidence indicates that conventional ferrous salts remain appropriate for clinically stable pa­tients with mild or moderate IDA, but gastrointestinal intolerance frequently limits adherence. Single morning dosing and alternate-day administration can improve fractional absorption by reducing hepcidin-mediated blockade. Ferric polymaltose and liposomal or sucrosomial formulations may improve gastrointestinal tolerability in selected patients. Intravenous iron provides faster restoration of hemoglobin and iron stores and is preferable when rapid correction is required, oral treatment is ineffective or poorly tolerated, malabsorption or active inflammation is present, or anemia is moderate to severe. Ferric carboxymaltose, ferric derisomaltose, and iron sucrose are effective, although formula­tion-specific adverse effects, especially hypophosphatemia after ferric carboxymaltose, require monitoring. The opti­mal strategy is not based on a single preparation but on matching the route, dose, schedule, urgency, underlying cause, and safety profile to the individual patient.</p>