What is anaemia medicine?

Anaemia medicines are used to treat anaemia, a condition where your blood test result shows a low red blood cell count or low haemoglobin level.  The medicine used to treat anaemia will depend on its cause. The most common type of anaemia is iron-deficiency anaemia, usually caused by not eating or absorbing enough iron, or by losing blood. It is common in rapidly growing children and teenagers, during pregnancy and in people with long-term conditions such as kidney disease. Medicines to treat iron-deficiency anaemia include tablets or liquids, or intravenous (IV) infusions that are given through the vein.

Other types of anaemia can be caused by folate deficiency, which is usually treated with folic acid tablets or vitamin b12 deficiency which is usually treated with hydroxocobalamin.

Anaemia caused by chronic kidney disease may need other treatments such as erythropoiesis-stimulating agents. These are medicines that send a signal to your body to make more red blood cells.

This article will focus on medicines to treat iron deficiency anaemia.

How does anaemia medicine work?

Iron-deficiency anaemia medicines aim to improve iron levels in blood. Because the body cannot make its own iron, these medicines slowly replace or supplement iron in the body.

Most medicines to treat iron-deficiency anaemia are taken orally and are available over the counter (OTC) without a doctor’s prescription. IVs to treat iron-deficiency anaemia are given in clinics and hospitals.

What types of anaemia medicine might I be given or prescribed?

Oral medicines are available in 2 forms, which are referred to as ferrous iron and ferric iron. Ferrous iron is preferred because the stomach is better able to absorb it.

Adults usually take 100mg to 200mg per day of oral medicines for iron-deficiency anaemia, divided into 2 or 3 doses. If you’re pregnant, you may need a lower dose, 60mg to 100mg per day. Children receive daily doses based on their body weight. These medicines include tablets and capsules. They also come in liquid form, which is preferred by children and some teenagers and adults.

Some of these medicines contain vitamin C, which helps the stomach to absorb iron.

If you tried taking oral medicines in the past but they didn’t help your condition, or if you need to increase your iron levels quickly, your doctor might prescribe an iron infusion. They will prescribe a dose based on how severe your iron-deficiency anaemia is and your body weight.

The specific type of IV medicines for iron-deficiency anaemia you receive varies by:

• dose
• cost
• how much time it takes for the IV infusion

Are there side effects or risks associated with anaemia medicine?

Some people report feeling nausea, diarrhoea, constipation or stomach pain after taking oral medicine. You might not have any side effects at all, or they may get better over time as your body gets used to the medicine. If you do experience side effects, your doctor might suggest a lower dose, taking them less often or taking them at night.

If you have constipation, try increasing the amount of fibre in your diet, drinking more water and using a mild laxative.

If you are pregnant, taking oral medicines to treat iron-deficiency anaemia may worsen nausea and vomiting. Talk to your doctor, midwife or pharmacist about options for trying a different medicine for anaemia.

Oral liquid medicines for iron-deficiency anaemia can stain teeth. Remember to brush your teeth straight after taking the liquid medicine.

IVs to treat iron-deficiency anaemia can occasionally cause serious side effects, such as allergic reaction, shortness of breath or rash. Your health team will monitor you closely during your IV infusion. You should not have iron infusions if you are in your first trimester of pregnancy, so tell your doctor if you think you might be pregnant. It’s also not recommended if you have an infection, or if you are not anaemic, even if your iron levels are low.

How should I take anaemia medicines?

How you take your oral medicine can affect how well it is absorbed into your blood. Here are some helpful tips:

• Take tablets or capsules whole — don’t crush or break them.
• Take these medicines on an empty stomach, around 1 hour before or 2 hours after eating.
• Try taking the medicine with a glass of water or juice.
• Do not drink tea, coffee, milk, chocolate, cola or wine with your medicine.

The length of time you will need to take medicine to treat iron-deficiency anaemia depends on the reasons for the deficiency. Usually, your treatment will continue for several months. If you are pregnant, you usually need to take these medicines for 6 to 8 weeks after your blood tests show normal iron levels.

When should I see my doctor?

The type of treatment you need will depend on what is causing your anaemia. Do not start taking medicines without first seeing your doctor. They will prescribe a medicine based on how severe your anaemia is, the availability and cost of medicines and how your body responds to the medicine.

Before taking medicines for iron-deficiency anaemia, tell your doctor or pharmacist if:

• you are taking other medicines
• your bowel motions (poos) look like dark tar or have red streaks
• you have stomach pain
• you have any other health concerns

Are there any alternatives to this medicine?

You may be able to increase your iron levels by eating iron-rich foods, but often this isn’t enough to treat iron-deficiency anaemia. Iron rich foods include lean red meats, chicken, fish, leafy green vegetables, wholemeal bread, iron-fortified cereals, legumes and eggs. Your body may also better absorb iron if you have foods and drinks rich in vitamin C.

Over-the-counter iron supplements don’t usually have enough iron to manage iron-deficiency anaemia. Some supplements might contain vitamins or minerals that can decrease the absorption of iron by the stomach.

Resources and support

• The National Blood Authority Australia has information on treating anaemia including a managing my iron fact sheet.
• The Australian Red Cross has information on iron deficiency, including medicines.