What is anaemia medicine?

Anaemia medicines are used to treat anaemia. Anaemia is a condition where your blood test result shows a low red blood cell count or low haemoglobin level. Anaemia can be caused by a range of medical conditions, and the medicine used to treat your anaemia depends on the cause.

The most common type of anaemia is iron-deficiency anaemia. It is usually caused by not eating or absorbing enough iron, or by losing blood. It is common in:

• females, especially those with heavy periods
• rapidly growing children and teenagers
• pregnancy
• people with long-term conditions such as kidney disease
• people that have difficulty absorbing nutrients
• children with a limited diet or who are 'picky eaters'

Medicines to treat iron-deficiency anaemia include:

• tablets
• liquids
• intravenous (IV) infusions that are given through a vein

Megaloblastic anaemia is another type of anaemia caused by problems with your red blood cells. This is often due to folate or vitamin B12 deficiency. Folate deficiency is usually treated with folic acid tablets and vitamin B12 deficiency 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 the blood.

Your body cannot make its own iron — you must get it from your diet or iron supplementation. Medicines that treat iron-deficiency anaemia slowly replace or supplement iron in the body.

Most medicines to treat iron-deficiency anaemia are taken orally. They are usually available over the counter (OTC) without a doctor's prescription. But often oral supplements are not enough to treat anaemia.

Iron infusions are given in clinics and hospitals, and are the most efficient method of treating iron deficiency anaemia.

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

You may be prescribed oral or intravenous medicine for your iron-deficiency anaemia.

Oral iron-deficiency medicines

Oral medicines come in 2 forms: ferrous iron and ferric iron, depending on their source.

Ferrous iron is generally preferred because the stomach is better able to absorb it. These medicines include tablets and capsules. They also come in liquid form, which is preferred by children and some teenagers and adults.

The recommended dose of oral medicines for adults for iron-deficiency anaemia is usually 100mg to 200mg, either daily or every second day. If you're pregnant, you may need a lower dose, depending on your stage of pregnancy. The right dose for children will depend on their body weight. Ask your child's doctor to determine the correct dose for your child.

Some oral iron formulations contain vitamin C, which helps the stomach to absorb iron.

Intravenous iron infusions

Your doctor might prescribe an iron infusion if you:

• tried taking oral medicines in the past but they didn't help your condition
• have problems absorbing iron supplements
• need to increase your iron levels quickly
• have significant symptoms
• have anaemia

They will prescribe a dose based on the severity of your iron-deficiency anaemia and your body weight.

There are a few iron formulations that can be used intravenously. Together with your doctor, you may decide which formulation is best for you based on:

• dose
• cost
• how much time it takes for the IV infusion
• any other medical condition you may have

Are there side effects or risks associated with anaemia medicine?

Side effects of oral anaemia medicines include:

• nausea
• diarrhoea
• constipation
• stomach pain
• black stool (faeces)

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 experience side effects, your doctor might suggest a lower dose, taking the medicine less often or taking them at night.

If you have constipation, try:

• increasing the amount of fibre in your diet
• drinking more water
• using a mild laxative

If you are pregnant, taking oral medicines to treat iron-deficiency anaemia may worsen nausea and vomiting. If you experience this, talk to your doctor, midwife or pharmacist about other options.

Iron infusions aren't recommended in the first trimester of pregnancy, so tell your doctor if you think you might be pregnant.

Iron infusions to treat iron-deficiency anaemia may cause flu-like symptoms or staining of the skin at the site of injection. Occasionally, they can cause serious side effects, such as:

• an allergic reaction
• shortness of breath
• a rash

Your health team will monitor you closely during your IV infusion.

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, about 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 or in the hour after.

Oral liquid medicines for iron-deficiency anaemia can stain your teeth, so it's a good idea to brush your teeth straight after taking the liquid medicine.

To avoid stomach-related side effects, try to stay in an upright position for at least 30 minutes after taking the medicine.

How long should I take anaemia medicines for?

The length of time you will need to take medicine to treat iron-deficiency anaemia will depend on the reasons for the deficiency. Usually, your treatment will continue for at least 3 to 6 months or until your levels have returned to the normal range.

If you are pregnant, you will 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:

• the cause of the anaemia
• how severe the anaemia is
• the availability and cost of medicines
• 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 abdominal pain
• you have any other health concerns

Talk to your doctor or pharmacist to find an anaemia medicine that works for you.

Are there any alternatives to this medicine?

You may be able to increase your iron levels by eating food high in iron, but often this isn't enough to treat iron-deficiency anaemia.

Iron rich foods include:

• lean red meats and chicken
• fish
• leafy green vegetables
• wholemeal bread
• iron-fortified cereals
• legumes
• eggs

Your body may also absorb dietary iron more effectively 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 multivitamin supplements might contain vitamins or minerals that can decrease the absorption of iron by the stomach. Check with your pharmacist if you have any questions about supplements.

Resources and support

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

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Languages other than English

SA Health has a page on iron deficiency and iron therapy with resources in 18 different languages.