Dosing Oral Iron to Improve Absorption

Background:  FeSO4 is often prescribed PO BID-TID.  Absorption is lessened by hepcidin, a peptide that blocks intestinal Fe absorption.
n = 54 non-anemic young women getting FeSO4 in successive QD or BID dosing schedules.
– hepcidin levels increase by 2.7x 24 hours after a dose
– increasing the dose associated with decrease in fractional Fe absorption
– daily doses led to 36% decrease in absorption on day two
– hepcidin levels significantly higher after BID compared to QD
– similar absorption with BID vs TID doses
Conclusion:  Higher Fe absorption if dosed q 48 hours, though giving more frequently increases absolute amount of Fe absorbed. QOD dosing may be better to increase absorption.  This study was not in iron-deficient patients, however.
Blood 2015 Oct 22; 126:1981

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