Skip to main content

Advertisement

Log in

Daily versus alternate day oral iron therapy in iron deficiency anemia: a systematic review

  • Review
  • Published:
Naunyn-Schmiedeberg's Archives of Pharmacology Aims and scope Submit manuscript

Abstract

Daily administration of oral iron is considered the current treatment standard for treating iron deficiency anemia due to availability and reduced cost compared to intravenous iron therapy. But adverse effects like epigastric pain, heartburn, and constipation reduce compliance to daily oral iron. There is scanty evidence regarding compliance and efficacy with alternate-day iron therapy. As per our knowledge, this is the first systematic review to compare daily with alternate-day oral iron therapy. Six electronic databases including PubMed and EMBASE were searched for randomized controlled trials, quasi-experimental studies published between January 2000 to March 2023 that compared daily with alternate day iron therapy in individuals diagnosed with iron deficiency anemia. The primary outcome analyzed was a change in hemoglobin. The other hematological parameters were assessed as secondary outcomes. Risk of bias was assessed regarding randomization process, deviation from intended intervention, missing outcome data, measurement of the outcome, and selection of the reported result. Out of the 9 full-text articles, 2 were not included as one was an ongoing trial and the second one had a different study design. The reviewed trials involved 594 participants, and the study participants ranged from 19 to 200. The mean age of the participants in the reported trials was 21 ± 2 to 49 ± 16 years. There is no significant increase in hemoglobin level and also the iron indices namely ferritin, hepcidin, total iron binding capacity, and reticulocyte count between daily and alternate-day dosing of iron. However, the frequency of adverse effects especially nausea, metallic taste, and altered bowel habits are reduced with alternate-day dosing. Oral iron given daily or on alternate days did not have a significant difference in the hemoglobin levels though iron absorption may be affected in the initial few days.

Trial registration: The review protocol was registered with PROSPERO (Prospero2023CRD42023393095).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

Not applicable.

References

Download references

Funding

No grant was received from any funding agency either from government or private sector for the conduct of the study.

Author information

Authors and Affiliations

Authors

Contributions

SK and VN conceived and designed the study. SK and EM developed the search strategy and did the literature search. SK, VN, RS, SH, and EM conducted the data extraction. SK, VN, and SH conducted the quality assessment of the selected studies. SK and VN wrote the initial draft of the manuscript. SK, VN, AB, EM, RS, and SH did the writing—review and editing. AB has provided valuable comments and clinical inputs to the manuscript. All authors have helped in drafting and approving the final version of the manuscript. The authors confirm that no paper mill and artificial intelligence was used.

Corresponding author

Correspondence to Veena Nayak.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

All authors approved manuscript in present format for publication.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 23 kb)

ESM 2

(DOCX 58 kb)

ESM 3

(DOCX 25 kb)

ESM 4

(PDF 108 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kamath, S., Parveen, R.S., Hegde, S. et al. Daily versus alternate day oral iron therapy in iron deficiency anemia: a systematic review. Naunyn-Schmiedeberg's Arch Pharmacol 397, 2701–2714 (2024). https://doi.org/10.1007/s00210-023-02817-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00210-023-02817-7

Keywords

Navigation