Iron is an essential constituent of the body and is required for the synthesis of heamoglobin, the cyto-chrome oxide enzymes and the myoglobin. The fatal iron content of the body usually varies between 2 to 5 gm depending upon the body weight and heamoglobin level. The body iron is distributed mainly as haeme, iron bound to protein (ferritin and heamosiderin). Physiological Role: It is a component of heamoglobin Cytochrome oxidase and myoglobin the majority be¬ing in RBCs as haemoglobin. Deficiency symptoms & signs : Iron deficiency anae¬mia characterised by microcytosis and hypochromia in peripheral blood film. Symptoms include tiredness, palpitations, tachycardia, body aches etc. Iron is absorbed from duodenum and upper jejunum. Iron from animal foods is generally better absorbed than that from vegetable foods. The absorption is in fer¬rous form. The total body iron is regulated Mostly by regulation of iron absorption in the gut transport of iron occurs via transferrin. Iron is stored as ferritin when body stores of iron are high. Excretion of iron occurs in faces with the exfoliation of villous cells, bile sweat, urine, menstrual blood, milk.

INDICATIONS : Oral therapy : Prophylaxis and treatment of iron deficiency anaemia which can occur in women of reproductive age grow, pregnancy, lacta¬tion, infants : anaemia due to acute or chronic blood loss. Iron atone or combination with vit B12 and orfolic acid can be given.

Parenteral therapy : When oral therapy cannot be given or where GI tract is unsuitable for iron absorption e.g. After gastrectomy or upper small intestinal inflammation.

CONTRAINDICATIONS : Haemolytic anaemias, Haemochromatosis, haemo-siderosis.

SAFETY PROFILE : GI discomfort due to iron therapy can be reduced by starting with small dose or by taking with meals. If intolerance occurs, stop the treatment.

ADVERSE EFFECT : Oral therapy : Nausea, epigastric discomfort, constipation or diarrhoea, black stools.

Parenteral therapy: Intramuscular route produces local pain, discoloration and potentially malignant skin changes. Intravenous route can cause anaphylaxis leading to death. Besides there can be headache, arthralgia, bronchospasm, fever. Antidote: Desferoxamine

DRUG INTERACTIONS : Mainly seen with oral iron therapy Food (especially egg and milk) & antacids reduce GI absorption of iron. Drugs like cimetidine and tetracyclines reduce GI absorption. Iron reduces the efficacy of levo-dopa, methyldopa .quinolones and penicillamine.

DOSAGE : Children 8-18 mg Adults 10-15 mg Menstruating women 15-20 mg Pregnancy & lactation 20-25 mg