Medications for anemia: Goal, options, and dose

The medication a doctor prescribes to treat anemia depends on the type of anemia a person has. For example, a person can take supplements to treat nutrient-deficiency anemia. More severe or chronic types of anemia will require different medications.

Iron deficiency anemia is the most common type and typically responds well to treatment with medication, including iron supplements.

This article looks at the goals of medication for anemia, which medications a person may require, how to take them, and how the medication works.

It also looks at the benefits and potential side effects of medication for anemia.

Medication treatment goals for anemia will differ depending on the type of anemia a person has and the underlying condition that is causing it.

For someone with mild anemia related to a nutrient-deficient diet or a temporary circumstance such as pregnancy, the goal may be to replenish lost nutrients and vitamins with supplements and other medication in the short term.

For others who experience chronic or severe anemia, the goals of medication can involve:

A person with iron deficiency anemia does not have enough iron in their body to produce a protein called hemoglobin.

This protein enables red blood cells to transport oxygen throughout the body, which is essential for the proper functioning of the organs.

Iron supplements are the most common treatment for anemia and can help replace iron levels in the body so that it can produce sufficient hemoglobin.

A person can typically get over-the-counter (OTC) iron supplements in oral pill form, as part of a multivitamin, or as an iron-only supplement. Types of iron supplements include:

A doctor may recommend a specific dosage.

In cases where anemia is not chronic, a person may require several supplements a day for 3–6 months to replenish their iron levels.

Individuals should take iron supplements exactly as the doctor directs, as too much iron may cause harmful side effects.

Iron supplements can help replenish the body's iron levels, which can relieve symptoms of anemia such as:

If a person does not receive treatment for anemia, they may be at risk of developing severe complications, such as heart problems.

There are various potential side effects of iron supplements, especially if a person takes high doses. These include:

In extremely high doses, iron becomes toxic and may cause severe side effects, such as:

Iron may also interact with other medications and supplements. A person should disclose any other medication they are taking with their doctor, including natural or herbal supplements.

To help mitigate the side effects associated with iron, a person may need to take a delayed or enteric-coated formulation.

If iron supplements are not adequate to replenish a person's iron levels, they may require intravenous (IV) iron.

A doctor may prescribe administering iron into a vein to increase iron levels in the blood, especially for patients with severe anemia who have a chronic condition, such as celiac disease.

The dosage of IV iron can differ depending on the intravenous iron formulation a doctor prescribes.

Dosages may range from 100 milligrams (mg) per dose of INFeD, the brand name for a compound called low-molecular-weight iron dextran, to 1,000mg of Monofer — the brand name for the compound iron isomaltoside.

The time it takes to administer the dose can range from 15 minutes to 6 hours.

IV iron may deliver iron into the blood more efficiently and in higher doses than iron supplements, which can result in better management of anemia symptoms.

Side effects may include:

Some types of anemia, such as pernicious anemia, develop because the body is deficient in vitamin B12, which it requires to produce healthy blood cells.

A doctor can prescribe vitamin B12 in the form of an injectable shot or a nasal spray. In less severe cases, a doctor may recommend large doses of vitamin B12 in pill form.

The supplemental vitamin B12 increases levels of the vitamin, which stimulates blood cell production.

The dosage may depend on the severity and type of anemia.

Doctors will typically prescribe administering a shot into a muscle every day for a week and once a month after a person's levels have normalized.

Benefits of vitamin B12 include:

Research has not found any harmful effects of vitamin B12, although it may interact with some medications. These include gastric acid inhibitors, and Metformin, which doctors use to treat diabetes.

It is very unlikely for a person to overdose on B12. This is because it is a water-soluble vitamin, meaning that any excess that the body does not absorb leaves the body via urine.

ESA is a synthetic form of a hormone the kidneys naturally produce, called erythropoietin (EPO). EPO helps stimulate the creation of red blood cells.

In people with certain conditions, such as chronic kidney disease, EPO levels are low, which can result in anemia. Synthetic ESA can stimulate red blood cell production in a similar way to the natural hormone.

A doctor can prescribe the medication and perform the injections themselves, or a person may be able to self-administer the injections at home.

The dosage depends on the underlying cause of the anemia and other factors.

For a person with chronic kidney disease-associated anemia, the dose may begin at 50–100 units per kilogram, three times a week. The dosage may differ for other types of anemia.

The medication can increase hemoglobin levels, which will reduce symptoms of anemia. This can also mean that a person with severe anemia may require fewer other types of treatment, such as blood transfusions.

A 2023 article notes that ESA can thicken the blood, which can increase the risk of blood clotting. This could lead to ischemic stroke and heart attack.

ESA may also increase the risk of certain cancers, such as cervical, lung, neck, and breast cancer.

In people who also undergo chemotherapy, side effects can include:

A doctor may prescribe other medications to treat underlying conditions that may contribute to or cause anemia. Many conditions may affect the production of red blood cells and cause anemia symptoms.

Medications for these conditions may include:

Below are the answers to some frequently asked questions about medication for anemia.

The best medication for anemia will depend on the type and severity of the condition. Iron supplements are the most common treatment for iron deficiency anemia.

The Food and Drug Administration (FDA) approved Jesduvroq tablets in February 2023.

The medication is the first oral treatment for anemia caused by chronic kidney disease, and doctors may prescribe it for adults who have received at least 4 months of dialysis.

There are different types of anemia, each with different causes and levels of severity, that may require different types of medication.

Common medication types include iron supplements, IV iron therapy, erythropoiesis-stimulating agents (ESA), and vitamin B12. Doctors may also prescribe medication to treat underlying conditions.

There are potential benefits and side effects of medication for anemia. Common side effects include nausea, vomiting, and other gastrointestinal upsets.