Safety profile of intravenous iron in inflammatory bowel disease: an up-to-date overview

Minerva Gastroenterol Dietol. 2020 Dec 3. doi: 10.23736/S1121-421X.20.02819-6.Online ahead of print.

Rocco Spagnuolo 1, Ludovico Abenavoli 2, Tiziana Larussa 3, Chiara Iannelli 3, Rinaldo Pellicano 4, Sharmila Fagoonee 5, Patrizia Doldo 1, Francesco Luzza 3


Author information

  • 1Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy.
  • 2Department of Health Sciences, Magna Graecia University, Catanzaro, Italy - l.abenavoli@unicz.it.
  • 3Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
  • 4Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy.
  • 5Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, Turin, Italy.


Up to 30-70% of patients may experience mild and moderate side effects during iron therapy and this is often associated with a poor adherence to therapy. Anemia is frequent in patients with active inflammatory bowel disease (IBD), due to both iron deficiency and chronic inflammation, therefore iron supplementation is frequently needed. Considering that gastrointestinal disorders are the most common side effects with oral iron, in IBD patients intravenous administration must be preferred. Although intravenous iron supplementation remains the most effective therapy of IBD-associated iron deficiency anemia, the perception of risk related to intravenous administration by clinicians could limit this successful strategy. In this narrative review we provide an up-to-date on the safety of the different iron formulations for intravenous administration, by reporting the most recent studies in IBD patients.

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