Correcting iron deficiency

Letter to the Editor My colleagues and I recently noted that the article on correcting iron deficiency did not include up-to-date information on intravenous iron replacement therapy in Australian hospitals.1 Iron polymaltose has been used for decades and in the last five years there have been additional clinical studies across several Victorian hospitals looking into the safety and rapid administration of high doses.2-6 This information was omitted from the article despite the new data on safety and adaptation of the rapid infusion protocol for iron replacement using the safe and cheaper alternative to the newer product ferric carboxymaltose. Patients who would benefit from ferric carboxymaltose are those with renal or heart failure who do not require doses over 1000 mg, and patients with mild–moderate iron deficiency requiring doses of 1000 mg or less with poor oral drug adherence or intolerance to oral supplements. Ferric carboxymaltose requires only a 15-minute infusion, however as we highlighted the total dose cannot exceed 1 g. It must be stressed that the product information does not currently support the rapid protocol for iron polymaltose and clinicians would need to discuss this approach with their drug and therapeutics committees if they wish to consider these changes.