The role of intravenous iron in anemia management and transfusion avoidance.

Parenteral iron preparations available in the past were associated with a risk of anaphylaxis and death, which made physicians reluctant to use them. The formulation most frequently responsible for these serious adverse events is high-molecularweight iron dextran (HMW ID). The availability, first in Europe and more recently in the USA, of three other preparations (low-molecular-weight [LMW] ID, iron sucrose, and ferric gluconate), with a much better safety profile, is changing the pattern of use, thus prompting this review of paradigms of anemia correction by intravenous (IV) iron administration, with an emphasis on transfusion avoidance...