Anemia Treatment

  • Treatment

    Seek medical help if you experience persistent weakness, fatigue, or paleness, dizziness, or heart palpitations.

    Oral iron supplements are usually advised for patients with anemia. Iron supplements should be used under a doctor's supervision [Table 2]. If your iron stores are low because of a serious health problem such as colon cancer, taking supplements could mask the symptom and delay diagnosis.

    If your doctor has prescribed iron supplements, take them as advised. It usually takes a few months to correct iron-deficiency anemia. Some people experience stomach upset from iron supplements. Nausea, diarrhea, and constipation are common, and iron supplements almost always turn the stool black (which is harmless). To minimize stomach irritation, take iron 30 minutes before eating, or ask your doctor if you can switch to a different preparation.

    A proper diet is usually all that is needed to correct anemia caused by a folic acid deficiency. Eat plenty of green vegetables, whole grains, and beans. Orange juice is another good source of folic acid. Doctors advise women of childbearing age to take a supplement containing 400 mcg of folic acid to protect against birth defects.

    Your doctor is the best source of information on the drug treatment choices available to you.

    Severe anemia cases warrant a blood transfusion. When blood loss happens quickly (from an accident or childbirth, for example), anemia can be fatal. In such cases, the bleeding must be stopped and red blood cells replaced via transfusion. Chronic illnesses, particularly in older people, sometimes result in blood loss that requires a transfusion as well.

    If you can't tolerate oral iron supplements, iron injections are an option. Intravenous iron administration is only needed in rare cases.

    If you have pernicious anemia, lifelong B12 injections are required. For pernicious anemia, monthly B12 injections are usually in order. You can give yourself injections, and your symptoms should clear up pretty quickly (within a week or so). For most people, injections do not produce side effects. Oral B12 is not the best option because the condition stems from the body's inability to absorb the vitamin. However, large doses may be tried if injections are out of the question.

    Anemia due to an enlarged spleen may be helped by spleen removal. The spleen is a major site of red blood cell destruction. An enlarged spleen may also reduce the number of white blood cells and platelets in the bloodstream. Treatment is typically targeted at the problem that caused the spleen to enlarge in the first place, but spleen removal may be necessary is some cases.

    Drugs that affect stomach acid (antacids, antihistamines, proton pump inhibitors) can interfere with iron absorption, and some medications may not work as well while you are taking iron. Be sure to tell your doctor about existing prescriptions. Drugs that interfere with iron include:

    • Antacids such as Maalox, Tums, and Mylanta
    • Histamine H2 receptor blockers for ulcers and heartburn, such as Cimetidine (Tagamet), Famotidine (Pepcid), Nizatide (Axid), and Ranitdine (Zantac)
    • Proton pump inhibitors such as omeprazole (Prilosec) for treatment of ulcers, heartburn, and other conditions where too much acid exists in stomach
    • Levodopa (Atamet, Laradopa, Sinemet) for treatment of Parkinson's disease
    • Methyldopa (Aldomet) for treatment of high blood pressure
    • Pencillamine (Cuprimine, Depen) for treatment of a variety of problems, including rheumatoid arthritis
    • Antibiotics such as norfloxacin (Chibroxin) and ciprofloxacin (Cipro), used for treatment of a variety of infections, including urinary tract infections and eye infections.
    • Tetracyclines such as micocyclin and tetracycline: antibiotics for treatment of a variety of problems, including acne

    Prognosis depends on the cause of anemia and how severe the condition is. The underlying cause of the anemia, such as heavy periods or slow stomach bleed from an ulcer must alwasy be corrected before blood stores can start to recover. Replenishing low iron stores usually takes a few months. A B12 deficiency can be corrected in a few weeks if there are no neurological complications. In such cases, it may take six months or longer for symptoms to clear. Sickle cell anemia is a chronic disease for which there is no cure. Attacks are usually managed with supportive care. Chronic illnesses, such as kidney disease or rheumatoid arthritis that lead to anemia, may have a more complex course, dpending on the severity of the chronic disease.

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